{"npi":"1891344271","type":"NPI-1","status":"active","name":{"display":"Nicole Clark Ma, Lcpc, Ncc","other":[],"first":"NICOLE","last":"CLARK","credential":"MA, LCPC, NCC"},"specialty":{"primary_taxonomy":"101YP2500X","primary_taxonomy_description":"Professional Counselor","slug":"professional-counselor","schema_org_specialty":null,"all":[{"code":"101YP2500X","description":"Professional Counselor","primary":true,"state":"IL","license":"180013967"}]},"addresses":[{"purpose":"LOCATION","street_1":"255 E LAKE ST STE 200","city":"BLOOMINGDALE","state":"IL","postal_code":"601081287","country_code":"US","phone":"8152955470"},{"purpose":"MAILING","street_1":"5564 W ARDMORE AVE","city":"CHICAGO","state":"IL","postal_code":"606466506","country_code":"US","phone":"8475671528"}],"license":{"state":"IL","number":"180013967"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20241203002127","type_code":"14-E2","type_desc":"PRACTITIONER - MENTAL HEALTH COUNSELOR","state":"IL","pac_id":"6507391372"}]},"enumeration_date":"2019-09-09","last_updated":"2026-04-29","_meta":{"source":"NPPES","snapshot_date":"2026-04-29","doc_url":"https://findmynpi.com/api"}}