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JENESIS E CLARK LPCC
NPI 1972125821
Counselor in Cincinnati, OH

Active since May 14, 2020PECOS Enrolled
3333 BURNET AVE ML 3015, CINCINNATI, OH 45229(513) 636-4336(513) 636-7756 Get Directions Write a Review

NPPES record last updated: March 20, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jenesis E Clark Lpcc NPPES

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

JENESIS E CLARK LPCC (NPI 1972125821) is an individual counselor in Cincinnati, Ohio, licensed in Ohio (E.2404016) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972125821
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameJENESIS E CLARKCredential: LPCC
Location Address3333 BURNET AVE ML 3015Cincinnati, OH 45229
Mailing Address5556 Clearview AveCincinnati, OH 45248-3216
Phone(513) 636-4336
Fax(513) 636-7756
Sole ProprietorYes
Enumeration DateMay 14, 2020
Last NPPES UpdateMarch 20, 2024
NPPES CertifiedMarch 20, 2024
✔ NPI 1972125821 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in OH · E.2404016
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License E.2404016 (OH)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3333 BURNET AVE ML 3015, Cincinnati, OH 45229
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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Mindfully, LLC
14 mi
Counselor
1251 NILLES RD STE 5
Fairfield, OH 45014
  • Reassigned Medicare billing, Ohio enrollment
  • 134 clinicians in this Medicare group
NPI 1972702520 (513) 939-0300

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.

CHIMEREODO OKOROJI
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-2025
MEGAN ELIZABETH NARAD M.A.
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-4336
SHIVALI SARAWGI
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-4336
DR. CAITLIN WESLEY PSYD
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-4336
ALEX NYQUIST PHD
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-4336
CLAIRE MARIE AARNIO-PETERSON PHD
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-4336
DR. MATTHEW JAMES MALEY PSY.D.
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-4336
KRISTEN CORNISH PSYD
Psychologist (Clinical Child & Adolescent)
3333 BURNET AVE ML 3015
CINCINNATI, OH 45229
Hamilton County (513) 636-4336

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 Jenesis Clark's NPI number?

The NPI number for Jenesis Clark is 1972125821. It was assigned to this individual provider in the NPPES registry on May 14, 2020.

Where is Jenesis Clark located?

Jenesis Clark practices at 3333 Burnet Ave Ml 3015, Cincinnati, OH 45229. The listed phone number is (513) 636-4336.

What is Jenesis Clark's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Jenesis Clark enrolled in Medicare?

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

Which organization bills Medicare for Jenesis Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jenesis Clark reassigns Medicare benefits to Mindfully, LLC (Fairfield, OH). 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 Jenesis Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jenesis Clark accept?

Health plans from CareSource, MedMutual, Oscar Health Insurance and Oscar Insurance Corporation of Ohio list Jenesis 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 Jenesis Clark was last updated on March 20, 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.