DR. SUSAN MARIE CLARK PH.D
NPI 1154590073
Counselor - Professional in Stockbridge, GA
NPI Status: Active since February 25, 2008
Contact Information
10 WILSON RD
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 438-4225
Fax: (770) 506-8663
- Individual
- Female
- Counselor
- Professional
- Accepts Insurance
- Opted-Out Medicare
About SUSAN CLARK
This page provides the complete NPI Profile along with additional information for Susan Clark, a provider established in Stockbridge, Georgia with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1154590073 assigned on February 2008. The practitioner's primary taxonomy code is 101YP2500X with license number LPC005485 (GA). The provider is registered as an individual and her NPI record was last updated 17 years ago.
- NPI
- 1154590073
- Provider Name
- DR. SUSAN MARIE CLARK PH.D
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 10 WILSON RD STOCKBRIDGE, GA 30281
- Location Phone
- (678) 438-4225
- Location Fax
- (770) 506-8663
- Mailing Address
- 10 WILSON RD STOCKBRIDGE, GA 30281
- Mailing Phone
- (678) 438-4225
- Mailing Fax
- (770) 506-8663
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 02-25-2008
- Last Update Date
- 01-05-2009
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Susan Clark opted out of Medicare effective on 02-11-2025 until 02-11-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- LPC005485
- License State
- GA
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | LPC005485 (GA) |
| 2 | 101YP1600X | Behavioral Health & Social Service Providers | Counselor | LPC005485 (GA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Value ($0 Virtual Urgent Care, $2 Tier 2 Rx, No Referrals) - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 02-11-2025
Opt-Out End Date: 02-11-2027
Eligible to Order and Refer? No
Reviews for DR. SUSAN MARIE CLARK PH.D
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 5 | 4 | 5 | 9 | 0 | 0 | 7 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 10 | 4 | 10 | 9 | 0 | 0 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 0 + 4 + 1 + 0 + 9 + 0 + 0 + 1 + 4 + 24 = 47 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 47 = 3 | 3 | ||||||||
The NPI number 1154590073 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 13 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1396822664 | MR. GREGORY T. SAMPLES LCSW Individual | Social Worker (Clinical) | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1649348244 | DANA ROCHON LCSW Individual | Social Worker (Clinical) | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 861-0252 |
| 1407915192 | KARA ELIZABETH ROGERS LICENSED COUNSELOR Individual | Counselor (Professional) | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1073643482 | A GROWTH PLACE, INC. Organization | Marriage & Family Therapist | 10 WILSON RD SUITE 1 STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1679699953 | MR. KELVIN LEON THOMPSON LPC Individual | Counselor (Professional) | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1841479821 | MARY JO SPITZNAGEL WHITE LPC, CRC Individual | Counselor (Professional) | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1356581896 | MRS. KIMBERLY P. ABERNATHY LPC Individual | Counselor (Professional) | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1649404674 | DON COTTON LPC Individual | Counselor | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1790085611 | DR. VALERIE CHILLIS SANDERS DMIN., LMFT Individual | Marriage & Family Therapist | 10 WILSON RD STOCKBRIDGE, GA 30281 (404) 502-2781 |
| 1588960710 | ANNE L. MCCULLOUGH LPC, NCC Individual | Counselor (Professional) | 10 WILSON RD SUITE 1 STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1619231941 | MRS. YVONNE MARIE MONGUE LPC Individual | Counselor (Professional) | 10 WILSON RD STOCKBRIDGE, GA 30281 (770) 506-9575 |
| 1972853638 | CLARK & CLARK COUNSELING CENTER, LLC Organization | Community/Behavioral Health | 10 WILSON RD SUITE 9 STOCKBRIDGE, GA 30281 (678) 438-4225 |
| 1245056993 | LEXI'S COMPASSION CARE LLC Organization | Home Health | 10 WILSON RD STE 101 # 1004 STOCKBRIDGE, GA 30281 (515) 401-3592 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154590073, enumerated in the NPI registry as an "individual" on February 25, 2008
The provider is located at 10 Wilson Rd Stockbridge, Ga 30281 and the phone number is (678) 438-4225
The provider's speciality is Counselor with taxonomy code 101YP2500X with a focus in Professional
The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
No, the provider signed an affidavit on February 11, 2025 to opt-out of the Medicare program. The provider is excluded from the Medicare program until February 11, 2027.
This NPI record was last updated on February 25, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.