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JESSICA ILO CLARK LPC, NCC
NPI 1902385875
Counselor - Professional in Simpsonville, SC

Active since August 10, 2018PECOS EnrolledAccepts Medicare Assignment
20 POWDERHORN RD, SIMPSONVILLE, SC 29681(864) 963-3421(864) 962-0758 Get Directions Write a Review

NPPES record last updated: August 20, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 20, 2023, Aug 10, 2018 (2 updates tracked since 2018).

About Jessica Ilo Clark Lpc, Ncc NPPES

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

JESSICA ILO CLARK LPC, NCC (NPI 1902385875) is an individual professional provider in Simpsonville, South Carolina, licensed in South Carolina (8125) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Moore, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1902385875
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJESSICA ILO CLARKCredential: LPC, NCC
Location Address20 POWDERHORN RDSimpsonville, SC 29681-3399
Mailing Address20 Powderhorn RdSimpsonville, SC 29681-3399 · (864) 963-3421 · Fax (864) 962-0758
Phone(864) 963-3421
Fax(864) 962-0758
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateAugust 10, 2018
Last NPPES UpdateAugust 20, 20232 updates tracked since enumeration
NPPES CertifiedAugust 20, 2023
✔ NPI 1902385875 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 SC · 8125
20 POWDERHORN RD, Simpsonville, SC 29681
Open in Google Maps ↗

Secondary Practice Location 1

Location 1591 Gas Plant RdMoore, SC 29369-9424 · Phone (602) 354-1562

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessica Ilo Clark Lpc, Ncc 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 ID941649800
PECOS Enrollment IDI20240411004537
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 Reassignments

2

Medicare enrollment records show Jessica Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

South Carolina Dept Of Mental Health Accounting Office
12 mi
Mental Health (Including Community Mental Health Center)
124 MALLARD ST
Greenville, SC 29601
  • Reassigned Medicare billing, South Carolina enrollment
  • 25 clinicians in this Medicare group
NPI 1013476787 (864) 241-1040
Talkspace Provider Network PA
617 mi
Mental Health (Including Community Mental Health Center)
2578 BROADWAY # 607
New York, NY 10025
  • Reassigned Medicare billing, South Carolina enrollment
  • 25 clinicians in this Medicare group
NPI 1639814049 (212) 284-7206

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 20

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

JACQUELYN WASHINGTON
Case Manager/Care Coordinator
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 963-3421
SHEILA SAMUEL JORDAN
Counselor (Mental Health)
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 963-3421
LAURA POINDEXTER
Counselor (Mental Health)
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 963-3421
PATRICIA JONES
Case Manager/Care Coordinator
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 963-3421
BRIAN DAVIS
Case Manager/Care Coordinator
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 963-3421
PAMELA RENEE JORDAN
Counselor (Mental Health)
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 297-5044
LALITA L DRAKE
Case Manager/Care Coordinator
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 963-3421
DANIEL JOHNSON
Counselor (Mental Health)
20 POWDERHORN RD
SIMPSONVILLE, SC 29681
Greenville County (864) 963-3421

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 Jessica Clark's NPI number?

The NPI number for Jessica Clark is 1902385875. It was assigned to this individual provider in the NPPES registry on August 10, 2018.

Where is Jessica Clark located?

Jessica Clark practices at 20 Powderhorn Rd, Simpsonville, SC 29681. The listed phone number is (864) 963-3421.

What is Jessica Clark's specialty?

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

Is Jessica Clark enrolled in Medicare?

Yes. Jessica 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.

Which organizations bill Medicare for Jessica Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessica Clark reassigns Medicare benefits to 2 organizations: South Carolina Dept Of Mental Health Accounting Office (Greenville, SC) and Talkspace Provider Network PA (New York, NY). Each 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 Jessica Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessica Clark accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Jessica 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 Jessica Clark was last updated on August 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.