ELIZABETH CLARK AMFT
NPI 1790271427
Marriage & Family Therapist in San Luis Obispo, CA

Q: What is Elizabeth Clark's NPI number?

The NPI number for Elizabeth Clark is 1790271427. It was assigned to this individual provider in the NPPES registry on July 5, 2018.

Q: What is Elizabeth Clark's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Elizabeth Clark enrolled in Medicare?

No. Elizabeth Clark has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Clark was last updated on July 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since July 05, 2018Opted out of Medicare · through Jan 1, 2028

1129 MARSH ST, SAN LUIS OBISPO, CA 93401(805) 543-7969 Get Directions Write a Review

NPPES record last updated: July 6, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Elizabeth Clark Amft NPPES

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

ELIZABETH CLARK AMFT (NPI 1790271427) is an individual marriage & family therapist in San Luis Obispo, California, licensed in California (AMFT106567) and active in the NPI registry since July 2018. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1790271427

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameELIZABETH CLARKCredential: AMFT

Location Address1129 MARSH STSan Luis Obispo, CA 93401

Mailing Address1129 Marsh StSan Luis Obispo, CA 93401-3323 · (805) 543-7969

Phone(805) 543-7969

Sole ProprietorYes

Enumeration DateJuly 5, 2018

Last NPPES UpdateJuly 6, 2018

✔ NPI 1790271427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · AMFT106567

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

1129 MARSH ST, San Luis Obispo, CA 93401

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Elizabeth Clark Amft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAUL WHITE B.S., M.A.

Marriage & Family Therapist