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NICOLE CLARK MA, LCPC, NCC
NPI 1891344271
Counselor - Professional in Bloomingdale, IL

Active since September 09, 2019PECOS Enrolled
255 E LAKE ST STE 200, BLOOMINGDALE, IL 60108(815) 295-5470 Get Directions Write a Review

NPPES record last updated: April 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 29, 2026, Mar 4, 2025, Sep 9, 2019 (3 updates tracked since 2019).

About Nicole Clark Ma, Lcpc, Ncc NPPES

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

NICOLE CLARK MA, LCPC, NCC (NPI 1891344271) is an individual professional provider in Bloomingdale, Illinois, licensed in Illinois (180013967) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891344271
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameNICOLE CLARKCredential: MA, LCPC, NCC
Location Address255 E LAKE ST STE 200Bloomingdale, IL 60108-1287
Mailing Address5564 W Ardmore AveChicago, IL 60646-6506 · (847) 567-1528
Phone(815) 295-5470
Sole ProprietorNo
Enumeration DateSeptember 9, 2019
Last NPPES UpdateApril 29, 20263 updates tracked since enumeration
NPPES CertifiedApril 29, 2026
✔ NPI 1891344271 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 IL · 180013967
255 E LAKE ST STE 200, Bloomingdale, IL 60108
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Clark Ma, Lcpc, Ncc 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.

Medicare Billing Reassignment

Medicare enrollment records show Nicole Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Essentially You Counseling And Wellness Services, LLC
Same address
Mental Health
255 E LAKE ST STE 200
Bloomingdale, IL 60108
  • Reassigned Medicare billing, Illinois enrollment
  • 5 clinicians in this Medicare group
NPI 1851802896 (815) 295-5470

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 9

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

MS. ERIN REDFERN LCPC
Counselor (Mental Health)
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (815) 295-5470
ASHLEY GRACE HOMOLKA
Counselor (Mental Health)
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (815) 295-5470
CHELSEA WILKEN LCSW
Social Worker (Clinical)
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (815) 295-5470
JESSICA BLUMBERG LCPC
Counselor (Professional)
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (815) 295-5470
AMARIAH CARNATE MA, LCPC
Counselor
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (630) 333-4012
ELIZABETH NANCY BULOW LCPC
Counselor (Mental Health)
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (815) 295-5470
ESSENTIALLY YOU COUNSELING AND WELLNESS SERVICES, LLC
Counselor (Mental Health)
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (815) 295-5470
EMILY MAGAZZU LPC
Counselor (Mental Health)
255 E LAKE ST STE 200
BLOOMINGDALE, IL 60108
Dupage County (815) 295-5470

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 Nicole Clark's NPI number?

The NPI number for Nicole Clark is 1891344271. It was assigned to this individual provider in the NPPES registry on September 9, 2019.

Where is Nicole Clark located?

Nicole Clark practices at 255 E Lake St Ste 200, Bloomingdale, IL 60108. The listed phone number is (815) 295-5470.

What is Nicole Clark's specialty?

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

Is Nicole Clark enrolled in Medicare?

Yes. Nicole Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Clark reassigns Medicare benefits to Essentially You Counseling And Wellness Services, LLC (Bloomingdale, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Clark was last updated on April 29, 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.