GRACIA CLARK – Professional Counselor, NPI 1417602251
Professional Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,847 MENTAL HEALTH COUNSELOR in MN
Provider Addresses for GRACIA CLARK
2350 STILLWATER AVE E APT 202
MAPLEWOOD, MN 551193667
Phone: (920) 344-5779
Type: Mailing
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 554254516
Phone:
Type: Mailing
403 STAGELINE RD
HUDSON, WI 540167848
Phone: (715) 531-6700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-02-13
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240213003389 | I | Mental Health Counselor | MN | TBD |
| I20240213003606 | I | Mental Health Counselor | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55119)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | WI | |
| Emergency Medicine | MN | |
| Emergency Medicine | WI | |
| Emergency Medicine | MN | |
| Emergency Medicine, Medical Toxicology | WI | |
| Emergency Medicine | MN | |
| Emergency Medicine | MN | |
| Mental Health Counselor | WY | |
| Emergency Medicine | MN | |
| Emergency Medicine, Internal Medicine | MN |
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