TERYL L CLARK LCSW
NPI 1588097786
Counselor - Professional in American Fork, UT
NPI Status: Active since August 12, 2013
Contact Information
789 BAMBERGER DR
SUITE A
AMERICAN FORK, UT
ZIP 84003
Phone: (801) 915-8792
- Individual
- Female
- Counselor
- Professional
- PECOS Enrolled
- Opted-Out Medicare
About TERYL CLARK
This page provides the complete NPI Profile along with additional information for Teryl Clark, a provider established in American Fork, Utah with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1588097786 assigned on August 2013. The practitioner's primary taxonomy code is 101YP2500X with license number 5970987-3501 (UT). The provider is registered as an individual and her NPI record was last updated 13 years ago.
- NPI
- 1588097786
- Provider Name
- TERYL L CLARK LCSW
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 789 BAMBERGER DR SUITE A AMERICAN FORK, UT 84003
- Location Phone
- (801) 915-8792
- Mailing Address
- 13478 S LONE ROCK DRAPER, UT 84020
- Mailing Phone
- (801) 915-8792
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-12-2013
- Last Update Date
- 08-12-2013
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Teryl Clark opted out of Medicare effective on 04-01-2017 until 04-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 5970987-3501
- License State
- UT
Medicare Participation & PECOS Enrollment Status
Teryl Clark is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2017
Opt-Out End Date: 04-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1588097786, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 74 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1588097786, enumerated as an "individual" on August 12, 2013.
The provider is located at 789 BAMBERGER DR SUITE A AMERICAN FORK, UT 84003 and the phone number is (801) 915-8792.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
