LATARIOUS CLARK
NPI 1659827673
Counselor - Professional in Athens, GA
About Latarious Clark NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LATARIOUS CLARK (NPI 1659827673) is an individual professional provider in Athens, Georgia, licensed in Georgia (LPC009108) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS.
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 (PECOS)
Latarious Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Latarious Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Athens, GA 30601
- Reassigned Medicare billing, Georgia enrollment
- 69 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 Latarious Clark's NPI number?
The NPI number for Latarious Clark is 1659827673. It was assigned to this individual provider in the NPPES registry on August 30, 2016.
Where is Latarious Clark located?
Latarious Clark practices at 135 Brentwood Dr, Athens, GA 30605. The listed phone number is (706) 224-4851.
What is Latarious Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Latarious Clark enrolled in Medicare?
Yes. Latarious Clark is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Latarious Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Latarious Clark reassigns Medicare benefits to Advantage Behavioral Health Systems (Athens, GA). 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 Latarious 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 Latarious Clark was last updated on August 30, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Latarious Clark · NPI 1659827673
Professional provider in Athens, Georgia. Individual provider, active in the CMS NPPES registry since August 30, 2016.
## Identity
- **NPI:** 1659827673 (Entity type: Individual)
- **Enumerated:** August 30, 2016
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC009108 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 135 BRENTWOOD DR, Athens, GA 30605-3901
- **Phone:** (706) 224-4851
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for durable medical equipment
- **Bills Medicare through:** Advantage Behavioral Health Systems (NPI 1942270558, Athens, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 30, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1659827673) · Data from the CMS NPPES public registry.