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JESSE WAYNE CLARK LPCC
NPI 1730517087
Counselor - Professional in Dayton, OH

Active since October 24, 2013PECOS Enrolled

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 2, 2018, Mar 17, 2018 (2 updates tracked since 2018).

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

NPI1730517087
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJESSE WAYNE CLARKCredential: LPCC
Location Address65 GRADY CTDayton, OH 45409
Mailing Address5400 Edalbert DrCincinnati, OH 45239-7604 · (937) 416-4031 · Fax (937) 534-1347
Phone(937) 416-4031
Sole ProprietorNo
Enumeration DateOctober 24, 2013
Last NPPES UpdateFebruary 24, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 24, 2026
✔ NPI 1730517087 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 OH · E.1600066
65 GRADY CT, Dayton, OH 45409
Open in Google Maps ↗

Secondary Practice Locations 2

Location 165 Grady CtDayton, OH 45409-1151 · Phone (937) 416-4031
Location 230 Overbrook Dr Ste CMonroe, OH 45050-1168 · Phone (513) 539-5250 · Fax (513) 539-5371

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jesse Wayne Clark Lpcc 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 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.

What insurance does Jesse Clark accept?

Health plans from CareSource 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 6 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.