MS. PENNY JAYMES CLARK L.M.H.C.
NPI 1912220161
Counselor - Mental Health in North Liberty, IA

Q: What is Penny Clark's NPI number?

The NPI number for Penny Clark is 1912220161. It was assigned to this individual provider in the NPPES registry on March 2, 2010.

Q: What is Penny Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: Is Penny Clark enrolled in Medicare?

No. Penny Clark has opted out of Medicare through August 1, 2028. 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 Penny Clark was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 March 02, 2010Opted out of Medicare · through Aug 1, 2028

1290 JORDAN ST, NORTH LIBERTY, IA 52317(319) 356-6352(319) 358-2367 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 21, 2022, Aug 17, 2017 (2 updates tracked since 2017).

On this page

About Ms. Penny Jaymes Clark L.m.h.c. NPPES

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

MS. PENNY JAYMES CLARK L.M.H.C. (NPI 1912220161) is an individual mental health provider in North Liberty, Iowa, licensed in Iowa (00733) and active in the NPI registry since March 2010. She has opted out of Medicare through August 1, 2028.

NPPES Registry Identity

NPI1912220161

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMS. PENNY JAYMES CLARKCredential: L.M.H.C.

Location Address1290 JORDAN STNorth Liberty, IA 52317-8020

Mailing Address1290 Jordan StNorth Liberty, IA 52317-8020 · (319) 356-6352 · Fax (319) 358-2367

Phone(319) 356-6352

Fax(319) 358-2367

Sole ProprietorYes

Enumeration DateMarch 2, 2010

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1912220161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in IA · 00733

1290 JORDAN ST, North Liberty, IA 52317

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Oscar Health, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Penny Jaymes Clark L.m.h.c. 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 August 1, 2024 through August 1, 2028.

Opt-Out Effective DateAugust 1, 2024

Opt-Out In Effect ThroughAugust 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

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.

FRANCIS GIULIANI

Psychiatry & Neurology (Psychiatry)