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NIKOLE CLARK MS
NPI 1578985552
Counselor - Mental Health in Watertown, NY

Active since January 10, 2014PECOS EnrolledAccepts Medicare Assignment
210 COURT ST STE 4, WATERTOWN, NY 13601(315) 783-0193 Get Directions Write a Review

NPPES record last updated: January 10, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1578985552
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameNIKOLE CLARKCredential: MS
Location Address210 COURT ST STE 4Watertown, NY 13601-4546
Mailing Address325 N Michigan AveWatertown, NY 13601-2936
Phone(315) 783-0193
Sole ProprietorYes
Medical School CMSOtherGraduated 1999
Enumeration DateJanuary 10, 2014
✔ NPI 1578985552 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 001882-1
210 COURT ST STE 4, Watertown, NY 13601
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

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.

PECOS PAC ID5294223350
PECOS Enrollment IDI20251021002684
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.

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.

What insurance does Nikole Clark accept?

Health plans from Providence Health Plan list Nikole Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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.