Active NPI 1841147865 Individual Practitioner Male Practitioner

Mitchell Clark

Counselor - Professional • Rockford, IL

Professional Overview & Biography Verified Profile Summary

Mitchell Clark is a registered healthcare professional specializing in Counselor - Professional in Rockford, IL. Practice services are available at 2704 N MAIN ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2704 N Main St

Rockford, IL 611033112

Telephone 8153911000

Associated Practice Facility / Clinic

🏢 Crusaders Central Clinic Association Facility NPI 1922358373

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Rockford, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 13.6 Yrs

State Avg: 17.0 Yrs

Regional Practice Density

172 Specialists

Practicing in Rockford, IL (9683 Statewide)

Telehealth Adoption Rate

5.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-03-11

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License IL 178.022813

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Logan Chapman-Neal

Counselor

NPI 1003372855

Jeremy Mcintosh

Counselor

NPI 1013570431

Jacob Wilson , BA

Counselor - Mental Health

NPI 1023318276

Bachelor of Arts

Nicole Estrada

Social Worker

NPI 1043040173

Robert Laib , LCPC

Counselor - Professional

NPI 1043435910

Licensed Clinical Professional Counselor

Terry Bunger

Registered Nurse - Addiction (Substance Use Disorder)

NPI 1043787419

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active March 11, 2026

NPI status registered as active in NPPES database

📍

Updated Practice Location March 11, 2026

Registered at 2704 N MAIN ST, ROCKFORD, IL 611033112 (Tel: 8153911000)

📍

Updated Business Mailing Address March 11, 2026

Registered at 3324 N JACKSON RD, PECATONICA, IL 610639224

👤

Provider Name / Credentials Updated March 11, 2026

Recorded as MITCHELL CLARK

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 11, 2026

Counselor (License #178.022813 in IL)

🟢

Initial NPI Registration & Enumeration March 11, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1841147865

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 11, 2026

Last Update: March 11, 2026

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

3324 N Jackson Rd

Pecatonica, IL 610639224

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.