Nicklaus Clark , LPC, LMHC
Counselor - Professional • Gresham, OR
1700 Nw Civic Dr, Suite 310
Gresham, OR 970303770
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
Practice Location & Contact Primary Location
1700 Nw Civic Dr
Suite 310
Gresham, OR 970303770
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Counselor - Professional: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2014
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Nicklaus Clark has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Nicklaus Clark as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Gresham and Oregon
35 active clinicians are listed under Counselor - Professional with a practice address in Gresham, OR (2,559 in Oregon).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Gresham
2.9% of these 35 clinicians have the CMS telehealth indicator.
11.4% of these 35 clinicians are listed by CMS as accepting Medicare assignment.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 101YP2500X
NUCC Taxonomy Code: 101YM0800X
NUCC Taxonomy Code: 101YP2500X
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - MENTAL HEALTH COUNSELOR
I20240725003988
OR
8325584386
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Psychologist
Doctor of Psychology (Psy.D.)
Career & Practice History
NPI enumerated November 03, 2014.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.
NPI Administrative Meta
Mailing Address
Po Box 82819
Portland, OR 972820819
Phone: 5032335405