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JOLIE CLARK LCSW
NPI 1710563549
Counselor in Oakland, CA

Active since March 22, 2021PECOS EnrolledAccepts Medicare Assignment
3715 MAGEE AVE, OAKLAND, CA 94619(415) 686-5741 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jolie Clark Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOLIE CLARK LCSW (NPI 1710563549) is an individual counselor in Oakland, California, licensed in California (100176) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1710563549
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameJOLIE CLARKCredential: LCSW
Location Address3715 MAGEE AVEOakland, CA 94619-1429
Mailing Address3715 Magee AveOakland, CA 94619-1429 · (415) 686-5741
Phone(415) 686-5741
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateMarch 22, 2021
NPPES CertifiedMarch 22, 2021
✔ NPI 1710563549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in CA · 100176
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
3715 MAGEE AVE, Oakland, CA 94619
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jolie Clark Lcsw 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 ID9032555727
PECOS Enrollment IDI20240317000125
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.

Medicare Billing Reassignment

Medicare enrollment records show Jolie Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
13 mi
Internal Medicine
2238 GEARY
San Francisco, CA 94116
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1841373800 (415) 833-2200

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 Jolie Clark's NPI number?

The NPI number for Jolie Clark is 1710563549. It was assigned to this individual provider in the NPPES registry on March 22, 2021.

Where is Jolie Clark located?

Jolie Clark practices at 3715 Magee Ave, Oakland, CA 94619. The listed phone number is (415) 686-5741.

What is Jolie Clark's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Jolie Clark enrolled in Medicare?

Yes. Jolie 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.

Which organization bills Medicare for Jolie Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jolie Clark reassigns Medicare benefits to Permanente Medical Group Inc (San Francisco, CA). 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 Jolie 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 Jolie Clark was last updated on March 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.