KORINNE L CLARK (MS,LPCC) – Counselor, NPI 1083967582

KORINNE L CLARK (MS,LPCC) is a healthcare provider. based in Kettering, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MS,LPCC. They hold a License No. E.2203025 (OH). The NPI Number for KORINNE L CLARK (MS,LPCC) is 1083967582

Main info

Female
34 Years Of Experience
Name
KORINNE L CLARK (MS,LPCC)
NPI
1083967582
Phone
(937) 293-1115
Address
1349 E STROOP RD
Enumeration Date
22 October 2012
Last Update Date
1 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1992 (34 years ago)
PAC ID
4183134364
Professional Enrollment ID
I20250606002114
Address ID
OH454391983MO3095XBLVD300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:13State licenses:1Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

Provider Addresses for KORINNE L CLARK (MS,LPCC)

  • 1349 E STROOP RD

    KETTERING, OH 454294925

    Phone: (937) 293-1115

    Type: Mailing

  • 3095 KETTERING BLVD

    MORAINE, OH 454391983

    Phone: (937) 293-8300

    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: 2025-06-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250606002114IMental Health CounselorOHTBD

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.

Verify on CMS Revalidation Lookup Tool

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 45429)

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Reviews

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Frequently asked questions

Does KORINNE L CLARK (MS,LPCC) have a public NPI I can cite?
Public records show KORINNE L CLARK (MS,LPCC) under NPI 1083967582.
Is KORINNE L CLARK (MS,LPCC)'s NPI status active today?
Active status means KORINNE L CLARK (MS,LPCC)'s NPI record is not deactivated in the public file.
Which specialty label fits KORINNE L CLARK (MS,LPCC)?
NPPES ties KORINNE L CLARK (MS,LPCC) to Counselor in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KORINNE L CLARK (MS,LPCC)?
KORINNE L CLARK (MS,LPCC) is associated with Kettering, Ohio in the same public data insurers reference.
Who maintains KORINNE L CLARK (MS,LPCC)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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