JENISE TRANNELL CLARK LPC
NPI 1851880926
Counselor in Fayetteville, GA

Q: What is Jenise Clark's NPI number?

The NPI number for Jenise Clark is 1851880926. It was assigned to this individual provider in the NPPES registry on May 4, 2018.

Q: What is Jenise Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jenise 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.

Active since May 04, 2018PECOS Enrolled

715 BRADLEY DR, FAYETTEVILLE, GA 30214(770) 358-5252 Get Directions Write a Review

NPPES record last updated: March 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 22, 2021, May 4, 2018 (2 updates tracked since 2018).

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About Jenise Trannell Clark Lpc NPPES

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

JENISE TRANNELL CLARK LPC (NPI 1851880926) is an individual counselor in Fayetteville, Georgia and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851880926

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameJENISE TRANNELL CLARKCredential: LPC

Location Address715 BRADLEY DRFayetteville, GA 30214-2030

Mailing Address3777 Waldrop LnDecatur, GA 30034-6786 · (404) 274-0929

Phone(770) 358-5252

Sole ProprietorNo

Enumeration DateMay 4, 2018

Last NPPES UpdateMarch 22, 20212 updates tracked since enumeration

NPPES CertifiedMarch 22, 2021

✔ NPI 1851880926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

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.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

715 BRADLEY DR, Fayetteville, GA 30214

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., CareSource, Providence Health Plan and more.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)

Jenise Trannell Clark Lpc 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.

Other Providers at the Same Location NPPES 7

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

MS. IRIS BRANCH CLEVELAND LCSW

Social Worker (Clinical)