STACY CLARK LMFT
NPI 1881047124
Marriage & Family Therapist in Lake Forest, CA

Q: What is Stacy Clark's NPI number?

The NPI number for Stacy Clark is 1881047124. It was assigned to this individual provider in the NPPES registry on July 21, 2016.

Q: What is Stacy Clark's specialty?

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

Q: Is Stacy Clark enrolled in Medicare?

No. Stacy Clark has opted out of Medicare through February 4, 2027. 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 Stacy Clark was last updated on April 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since July 21, 2016Opted out of Medicare · through Feb 4, 2027

23832 ROCKFIELD BLVD STE 120, LAKE FOREST, CA 92630(949) 415-8631 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 1, 2025, Mar 11, 2025 (2 updates tracked since 2025).

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About Stacy Clark Lmft NPPES

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

STACY CLARK LMFT (NPI 1881047124) is an individual marriage & family therapist in Lake Forest, California, licensed in California (MFT35323) and active in the NPI registry since July 2016. She has opted out of Medicare through February 4, 2027 and maintains a secondary practice location in Mountain View.

NPPES Registry Identity

NPI1881047124

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameSTACY CLARKCredential: LMFT

Location Address23832 ROCKFIELD BLVD STE 120Lake Forest, CA 92630-2870

Mailing Address23832 Rockfield Blvd Ste 120Lake Forest, CA 92630-2870 · (949) 415-8631

Phone(949) 415-8631

Sole ProprietorNo

Enumeration DateJuly 21, 2016

Last NPPES UpdateApril 1, 20252 updates tracked since enumeration

NPPES CertifiedApril 1, 2025

✔ NPI 1881047124 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 · MFT35323

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.

23832 ROCKFIELD BLVD STE 120, Lake Forest, CA 92630

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Secondary Practice Location 1

Location 12660 Solace Pl Ste D2Mountain View, CA 94040-4337 · Phone (949) 415-8631

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Stacy Clark Lmft 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 February 4, 2025 through February 4, 2027.

Opt-Out Effective DateFebruary 4, 2025

Opt-Out In Effect ThroughFebruary 4, 2027Opt-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.

FARHAD NIKOO INC

Clinical Nurse Specialist (Psychiatric/Mental Health)