Nicklaus Clark, LPC, LMHC
NPI 1407251408ActiveIndividual· Counselor, Professional· Gresham, OR
Counselor, Professional (LPC, LMHC) in Gresham, Oregon, licensed in OR, WA and MO, with an NPI issued in November 2014. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1407251408 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPC, LMHC |
| Sole proprietor | No |
| NPI issued | Nov 3, 2014 |
| Last updated in NPPES | Feb 4, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | C3550 | OR |
| Counselor, Mental Health | 101YM0800X | LH60497951 | WA |
| Counselor, Professional | 101YP2500X | 2012024654 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (OR) |
|---|
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