JESSE WAYNE CLARK LPCC
NPI 1730517087
Counselor - Professional in Dayton, OH
About Jesse Wayne Clark Lpcc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSE WAYNE CLARK LPCC (NPI 1730517087) is an individual professional provider in Dayton, Ohio, licensed in Ohio (E.1600066) and active in the NPI registry since October 2013. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
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)
Jesse Wayne Clark Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Jesse Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Dublin, OH 43017
- Reassigned Medicare billing, Ohio enrollment
- 200 clinicians in this Medicare group
Columbus, OH 43215
- Reassigned Medicare billing, Ohio enrollment
- 39 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 Jesse Clark's NPI number?
The NPI number for Jesse Clark is 1730517087. It was assigned to this individual provider in the NPPES registry on October 24, 2013.
Where is Jesse Clark located?
Jesse Clark practices at 65 Grady Ct, Dayton, OH 45409. The listed phone number is (937) 416-4031.
What is Jesse Clark's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Jesse Clark enrolled in Medicare?
Yes. Jesse Clark is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Jesse Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jesse Clark reassigns Medicare benefits to 2 organizations: Viaquest Psychiatric & Behavioral Solutions LLC (Dublin, OH) and Brighter Day Oh LLC (Columbus, OH). Each 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 Jesse Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jesse Clark accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance and 2 other insurers list Jesse 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 Jesse Clark was last updated on February 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.
# Jesse Wayne Clark, LPCC · NPI 1730517087
Professional provider in Dayton, Ohio. Individual provider, active in the CMS NPPES registry since October 24, 2013.
## Identity
- **NPI:** 1730517087 (Entity type: Individual)
- **Enumerated:** October 24, 2013
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** E.1600066 (Ohio)
- **Sole proprietor:** No
## Practice location
- **Address:** 65 GRADY CT, Dayton, OH 45409
- **Phone:** (937) 416-4031
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Viaquest Psychiatric & Behavioral Solutions LLC (NPI 1386155711, Dublin, OH); Brighter Day Oh LLC (NPI 1780449140, Columbus, OH) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 24, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1730517087) · Data from the CMS NPPES public registry.