Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Leesa G Clark, LICDC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1447610910

Leesa G Clark, LICDC is a Mental Health Counselor in Lorain, Ohio. Qualified in 2011, 15 years ago. Practices as a sole proprietor. Licensed in Ohio.

Years since qualifying
15
Licensed in
OH
In the registry since
2016
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Practice location Address checks out

2115 W Park Dr
Lorain, OH 44053-1138
Phone: (440) 989-4987
Fax: (440) 282-4779
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence ICDC.081105 (OH)

Record details

NPI number1447610910
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICDC
Sole proprietorYes
NPI enumeratedFebruary 26, 2016
Last updated in NPPESJuly 7, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Not indicated

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