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Active NPI 1730517087 Individual Practitioner Male Practitioner

Jesse Wayne Clark , LPCC

Counselor - Professional • Dayton, OH

Professional Overview & Biography Verified Profile Summary

Jesse Clark, LPCC is a registered healthcare professional specializing in Counselor - Professional in Dayton, OH. Practice services are available at 65 GRADY CT under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

65 Grady Ct

Dayton, OH 45409

Telephone 9374164031
Associated Practice Facility / Clinic
🏢 Veronica R. Berning Facility NPI 1992124580

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.3 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
132 Specialists

Practicing in Dayton, OH (6923 Statewide)

Telehealth Adoption Rate
6.8% 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: 2026-02-24
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OH E.1600066

Definition to come...

Secondary Practice Locations

65 Grady Ct

Dayton, OH 454091151

Phone: 9374164031

30 Overbrook Dr Ste C

Monroe, OH 450501168

Phone: 5135395250

65 Grady Ct

Dayton, OH 454091151

Phone: 9374164031

Career & Practice History Timeline

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

15 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 24, 2026

Counselor (License #E.1600066 in OH)

📍
Updated Practice Location August 02, 2018

Registered at 65 GRADY CT, DAYTON, OH 45409 (Tel: 9374164031)

📍
Updated Business Mailing Address August 02, 2018

Registered at 5400 EDALBERT DR, CINCINNATI, OH 452397604 (Tel: 9374164031)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Counselor (License #C.1200356 in OH)

✅
NPI Profile Active October 13, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location October 13, 2017

Registered at 65 GRADY CT, DAYTON, OH 454091151 (Tel: 9374164031)

📍
Updated Business Mailing Address October 13, 2017

Registered at 3095 KETTERING BLVD, MORAINE, OH 454391983 (Tel: 9372938300)

👤
Provider Name / Credentials Updated October 13, 2017

Recorded as JESSE CLARK, LPCC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 13, 2017

Counselor (License #E.1600066 in OH)

✅
NPI Profile Active October 24, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location October 24, 2013

Registered at 3095 KETTERING BLVD, MORAINE, OH 454391983 (Tel: 9372938300)

📍
Updated Business Mailing Address October 24, 2013

Registered at 3095 KETTERING BLVD, MORAINE, OH 454391983 (Tel: 9372938300)

👤
Provider Name / Credentials Updated October 24, 2013

Recorded as JESSE CLARK, PC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 24, 2013

Counselor (License #C.1200356 in OH)

🟢
Initial NPI Registration & Enumeration October 24, 2013

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: 1730517087
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 24, 2013
Last Update: February 24, 2026
Sole Proprietor: No
Update or Correct Profile

Mailing Address

5400 Edalbert Dr

Cincinnati, OH 452397604

Phone: 9374164031

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.