CANDACE CLARK PCC
NPI 1629327101
Counselor - Professional in Berea, OH
About Candace Clark Pcc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CANDACE CLARK PCC (NPI 1629327101) is an individual professional provider in Berea, Ohio, licensed in Ohio (E.0600652) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2007).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Candace Clark Pcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Candace Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
North Ridgeville, OH 44039
- Reassigned Medicare billing, Ohio enrollment
- 17 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.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BEREA, OH 44017
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 Candace Clark's NPI number?
The NPI number for Candace Clark is 1629327101. It was assigned to this individual provider in the NPPES registry on August 30, 2012.
Where is Candace Clark located?
Candace Clark practices at 202 East Bagley Road, Berea, OH 44017. The listed phone number is (800) 234-2006.
What is Candace Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Candace Clark enrolled in Medicare?
Yes. Candace Clark is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Candace Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Candace Clark reassigns Medicare benefits to Phoenix Counseling Center LLC (North Ridgeville, OH). 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 Candace Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Candace Clark accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 5 other insurers list Candace 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 Candace Clark was last updated on August 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Candace Clark, PCC · NPI 1629327101
Professional provider in Berea, Ohio. Individual provider, active in the CMS NPPES registry since August 30, 2012.
## Identity
- **NPI:** 1629327101 (Entity type: Individual)
- **Enumerated:** August 30, 2012
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** E.0600652 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 202 EAST BAGLEY ROAD, Berea, OH 44017-2058
- **Phone:** (800) 234-2006
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Phoenix Counseling Center LLC (NPI 1801309141, North Ridgeville, OH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2007
## Record status
- **NPPES last updated:** August 30, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1629327101) · Data from the CMS NPPES public registry.