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LATARIOUS CLARK
NPI 1659827673
Counselor - Professional in Athens, GA

Active since August 30, 2016PECOS Enrolled
135 BRENTWOOD DR, ATHENS, GA 30605(706) 224-4851 Get Directions Write a Review

NPPES record last updated: August 30, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

NPI1659827673
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameLATARIOUS CLARK
Location Address135 BRENTWOOD DRAthens, GA 30605-3901
Mailing Address135 Brentwood DrAthens, GA 30605-3901
Phone(706) 224-4851
Sole ProprietorYes
Enumeration DateAugust 30, 2016
✔ NPI 1659827673 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC009108
135 BRENTWOOD DR, Athens, GA 30605
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Latarious Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 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.

When was this NPI record last updated?

The NPPES record for Latarious Clark was last updated on August 30, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.