NIKOLE CLARK MS
NPI 1578985552
Counselor - Mental Health in Watertown, NY
About Nikole Clark Ms NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NIKOLE CLARK MS (NPI 1578985552) is an individual mental health provider in Watertown, New York, licensed in New York (001882-1) and active in the NPI registry since January 2014. She is enrolled in Medicare PECOS and is a graduate of Other (1999).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Nikole Clark Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Nikole Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Saratoga Springs, NY 12866
- Reassigned Medicare billing, New York enrollment
- 127 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Nikole Clark's NPI number?
The NPI number for Nikole Clark is 1578985552. It was assigned to this individual provider in the NPPES registry on January 10, 2014.
Where is Nikole Clark located?
Nikole Clark practices at 210 Court St Ste 4, Watertown, NY 13601. The listed phone number is (315) 783-0193.
What is Nikole Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Nikole Clark enrolled in Medicare?
Yes. Nikole Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Nikole Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nikole Clark reassigns Medicare benefits to Professional Medical Concierge Services, PLLC (Saratoga Springs, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nikole Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Nikole Clark was last updated on January 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.
# Nikole Clark, MS · NPI 1578985552
Mental Health provider in Watertown, New York. Individual provider, active in the CMS NPPES registry since January 10, 2014.
## Identity
- **NPI:** 1578985552 (Entity type: Individual)
- **Enumerated:** January 10, 2014
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 001882-1 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 210 COURT ST STE 4, Watertown, NY 13601-4546
- **Phone:** (315) 783-0193
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Professional Medical Concierge Services, PLLC (NPI 1841812310, Saratoga Springs, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1999
## Record status
- **NPPES last updated:** January 10, 2014
---
Source: [NPI Profile](https://npiprofile.com/npi/1578985552) · Data from the CMS NPPES public registry.