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NATHANIEL P CLARK LCPC-C
NPI 1891155792
Counselor - Professional in Portland, ME

Active since March 04, 2016PECOS EnrolledAccepts Medicare Assignment
11 BAXTER BLVD, PORTLAND, ME 04101(207) 774-8700(207) 422-7268 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2019, Mar 4, 2016 (2 updates tracked since 2016).

About Nathaniel P Clark Lcpc-c NPPES

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

NATHANIEL P CLARK LCPC-C (NPI 1891155792) is an individual professional provider in Portland, Maine, licensed in Maine (CC5420) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1891155792
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameNATHANIEL P CLARKCredential: LCPC-C
Location Address11 BAXTER BLVDPortland, ME 04101-1801
Mailing Address11 Baxter BlvdPortland, ME 04101-1801 · (207) 774-8700 · Fax (207) 422-7268
Phone(207) 774-8700
Fax(207) 422-7268
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMarch 4, 2016
Last NPPES UpdateJanuary 9, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2024
✔ NPI 1891155792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in ME · CC5420
Also ListedCounselorTaxonomy 101Y00000X · License XL4658 (ME)
11 BAXTER BLVD, Portland, ME 04101
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1155 Center St, Building FAuburn, ME 04210-5229 · Phone (207) 777-5888 · Fax (207) 777-5802
Location 21155 Lisbon StLewiston, ME 04240-5025 · Phone (207) 783-9141 · Fax (207) 376-3808

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nathaniel P Clark Lcpc-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496192809
PECOS Enrollment IDI20240321000350
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 11

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

NICOLE FIRTH LCSW
Social Worker (Clinical)
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (207) 828-4026
JACOB LAPIERRE LCSW
Social Worker (Clinical)
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (207) 857-7426
JENNIFER KELLEY-YOUNG LADC
Counselor (Addiction (Substance Use Disorder))
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (207) 775-5671
CHELSEA DUNTON PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (207) 828-4026
STEPHANIE F POTTS
Counselor (Addiction (Substance Use Disorder))
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (207) 775-5671
MRS. DEBRA A OUIMETTE PHD, LADC, CASAC,SAP
Counselor (Addiction (Substance Use Disorder))
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (207) 775-5671
CATHOLIC CHARITIES MAINE
Community/Behavioral Health
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (207) 775-5671
JULIA LAUREN PARKS LCSW
Social Worker (Clinical)
11 BAXTER BLVD
PORTLAND, ME 04101
Cumberland County (603) 883-0005

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 Nathaniel Clark's NPI number?

The NPI number for Nathaniel Clark is 1891155792. It was assigned to this individual provider in the NPPES registry on March 4, 2016.

Where is Nathaniel Clark located?

Nathaniel Clark practices at 11 Baxter Blvd, Portland, ME 04101. The listed phone number is (207) 774-8700.

What is Nathaniel Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Nathaniel Clark enrolled in Medicare?

Yes. Nathaniel Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nathaniel Clark accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Nathaniel 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 Nathaniel Clark was last updated on January 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.