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JEROD CLARK
NPI 1952015141
Counselor - Mental Health in Cleveland, OK

Active since January 11, 2023PECOS Enrolled
907 W CADDO ST, CLEVELAND, OK 74020(918) 607-5576 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jerod Clark NPPES

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

JEROD CLARK (NPI 1952015141) is an individual mental health provider in Cleveland, Oklahoma and active in the NPI registry since January 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952015141
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJEROD CLARK
Location Address907 W CADDO STCleveland, OK 74020-4201
Mailing Address907 W Caddo StCleveland, OK 74020-4201 · (918) 607-5576
Phone(918) 607-5576
Sole ProprietorNo
Enumeration DateJanuary 11, 2023
NPPES CertifiedJanuary 11, 2023
✔ NPI 1952015141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
907 W CADDO ST, Cleveland, OK 74020
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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerod Clark 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 Jerod Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grand Lake Mental Health Center, Inc.
Same address
Mental Health (Including Community Mental Health Center)
907 W CADDO ST
Cleveland, OK 74020
  • Reassigned Medicare billing, Oklahoma enrollment
  • 333 clinicians in this Medicare group
NPI 1609434257 (918) 305-5511

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.

MALCOLM JOHN WHITE
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 273-1841
RITA CARMEN RODRIGUEZ
Peer Specialist
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 273-1841
DANIEL ANTWAIN SHAW
Social Worker
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 308-5511
ADRIAN DEAN EDDINGS
Peer Specialist
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 308-5511
CARRIE RENE HOLLOWAY
Community/Behavioral Health
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (844) 458-2100
MRS. AMY COMPTON
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 358-5339
KELLY MCDONALD
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (918) 308-5511
ISAAC JAMES DEAN
Case Manager/Care Coordinator
907 W CADDO ST
CLEVELAND, OK 74020
Pawnee County (844) 458-2100

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 Jerod Clark's NPI number?

The NPI number for Jerod Clark is 1952015141. It was assigned to this individual provider in the NPPES registry on January 11, 2023.

Where is Jerod Clark located?

Jerod Clark practices at 907 W Caddo St, Cleveland, OK 74020. The listed phone number is (918) 607-5576.

What is Jerod Clark's specialty?

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

Is Jerod Clark enrolled in Medicare?

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

Which organization bills Medicare for Jerod Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jerod Clark reassigns Medicare benefits to Grand Lake Mental Health Center, Inc. (Cleveland, OK). 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 Jerod Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jerod Clark accept?

Health plans from Blue Cross and Blue Shield of Oklahoma and Oscar Insurance Company list Jerod 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 Jerod Clark was last updated on January 11, 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.