1. Home
  2. Directory
  3. Georgia
  4. Marietta
  5. Counselor
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AUTUMN ROSE CLARK
NPI 1528908688
Counselor - Professional in Marietta, GA

Active since March 30, 2026PECOS Enrolled
2440 SANDY PLAINS RD STE 200, MARIETTA, GA 30066(619) 342-5933 Get Directions Write a Review

NPPES record last updated: September 4, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Sep 4, 2026, Mar 30, 2026 (2 updates tracked since 2026).

About Autumn Rose Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AUTUMN ROSE CLARK (NPI 1528908688) is an individual professional provider in Marietta, Georgia, licensed in Georgia (APC010509) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1528908688
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameAUTUMN ROSE CLARK
Location Address2440 SANDY PLAINS RD STE 200Marietta, GA 30066-7217
Mailing Address2440 Sandy Plains Rd Ste 200Marietta, GA 30066-7217 · (619) 342-5933
Phone(619) 342-5933
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 30, 2026
Last NPPES UpdateSeptember 4, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2026
✔ NPI 1528908688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · APC010509
2440 SANDY PLAINS RD STE 200, Marietta, GA 30066
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Autumn Rose Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577037555
PECOS Enrollment IDI20260630004205
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHARLES WAYNE NEAL DC
Chiropractor
2440 SANDY PLAINS RD STE 200
MARIETTA, GA 30066
Cobb County (404) 381-7042
ALLISON COUNSELING SERVICES, LLC
Social Worker (Clinical)
2440 SANDY PLAINS RD STE 200
MARIETTA, GA 30066
Cobb County (470) 363-1787
ALIEXO CHRISTIE LCSW
Social Worker (Clinical)
2440 SANDY PLAINS RD STE 200
MARIETTA, GA 30066
Cobb County (678) 346-1900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Autumn Clark's NPI number?

The NPI number for Autumn Clark is 1528908688. It was assigned to this individual provider in the NPPES registry on March 30, 2026.

Where is Autumn Clark located?

Autumn Clark practices at 2440 Sandy Plains Rd Ste 200, Marietta, GA 30066. The listed phone number is (619) 342-5933.

What is Autumn Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Autumn Clark enrolled in Medicare?

Yes. Autumn Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Autumn Clark was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.