TINA MICHELLE CLARK (NPI# 1104030899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104030899 |
| Entity Type | Individual |
| Full Name | TINA MICHELLE CLARK |
| Practice Address |
135 W Main St Chehalis WA 98532-4817 |
| Mailing Address |
1313 Ferrier Rd Winlock WA 98596-9330 |
| Practice Telephone | 3607486696 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
RC00049995 | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363665 | Tina M Clark | Social Worker | 7150 Millbrook St, Shawnee, KS 66218-9235 | 2020-10-12 |
| 1366972978 | Tina Clark | Community/Behavioral Health | 2951 Albrecht Ave Apt 14, Akron, OH 44312-7406 | 2017-06-15 |
| 1164078069 | Tina Elizabeth Clark | Social Worker | 23700 Camino Del Sol, Torrance, CA 90505-5000 | 2019-08-15 |
| 1871000877 | Tina Marie Clark | Peer Specialist | 411 S Central Ave, Idabel, OK 74745-6059 | 2017-12-29 |
| 1326583196 | Tina Clark | Nurse Practitioner | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2017-01-03 |
| 1730327040 | Tina Clark | Counselor | 221 West Main Street, Jefferson, NC 28640-9723 | 2009-01-23 |
| 1386839843 | Tina Marie Clark | Rehabilitation Counselor | 7200 Skyway, Paradise, CA 95969-3280 | 2007-09-07 |
| Street Address |
135 W MAIN ST |
| City | CHEHALIS |
| State | WA |
| Zip Code | 98532-4817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285255943 | Crystal Dawn Wilson | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2020-05-04 |
| 1225659212 | Michael Koplin | Peer Specialist | 135 W Main St, Chehalis, WA 98532-4817 | 2020-04-30 |
| 1396375002 | Erica Renee Gavin | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2020-01-22 |
| 1639731755 | Breeann Delynn Bryson | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-06-28 |
| 1730749987 | Joseph Seung Chinn | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-06-19 |
| 1518522929 | Safiyatu Njai | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-05-01 |
| 1114581261 | Nickolas Casey Root | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-04-24 |
| 1972061653 | Jason Still | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-03-12 |
| 1285192567 | Meagan Marina Gallegos | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-03-06 |
| 1336606888 | Whitney Felkl | Counselor | 135 W Main St, Chehalis, WA 98532-4817 | 2019-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140832 | Joshua Russell Wachter | Registered Nurse | 275 W. Vine St., Napavine, WA 98532 | 2020-09-28 |
| 1891339123 | Dara Casey | Technician | 271-1 Romerman Rd, Chehalis, WA 98532 | 2019-10-30 |
| 1265997704 | April D Bacongco | Counselor | 500 Se Washington St, Chehalis, WA 98532 | 2019-02-08 |
| 1235610155 | Alyssa Dawn Ware | Physical Therapist | 1441 Kresky Ave, Chehalis, WA 98532 | 2018-08-28 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1043709314 | Kevin Bumatay Duran | Family Medicine | 931 S. Market Blvd, Chehalis, WA 98532 | 2018-05-02 |
| 1164922324 | William I. Mcmillan | Counselor | 121 Nw Chehalis St., Chehalis, WA 98532 | 2018-02-14 |
| 1285155366 | Great Rivers Behavioral Health Organization | Community/Behavioral Health | 57 W Main Street, Suite 260, Chehalis, WA 98532 | 2017-06-29 |
| 1396273637 | Misty Anne Glenn | Counselor | 121 Nw Chehalis Ave, Chehalis, WA 98532 | 2017-05-31 |
| 1841726221 | Dodi Forgione | Counselor | 2401 Ne Kresky Ave Ste D, Chehalis, WA 98532 | 2017-05-04 |
| Find all providers in zip 98532 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477021459 | Andres Perez | Counselor | 151 N Market Blvd Ste D, Chehalis, WA 98532-2677 | 2018-11-07 |
| 1205360096 | Shelbie May Robinson | Counselor | 653 Ne Franklin Ave, Chehalis, WA 98532-2123 | 2017-04-18 |
| 1790217628 | Michael Vernon Blankinship | Counselor | 28 Sw Chehalis Ave, Chehalis, WA 98532-1933 | 2017-03-30 |
| 1134502933 | Michael Dean Rose | Counselor | 124 Bear View Dr, Chehalis, WA 98532-9545 | 2015-06-30 |
| 1396144788 | Erin Fieldstad | Counselor | 272 Frogner Rd, Chehalis, WA 98532-9142 | 2014-08-21 |
| 1841540051 | Brigitte R. Macdonald | Counselor | 180 Sw Alfred St, Chehalis, WA 98532-4804 | 2012-09-14 |
| 1902071913 | Julie Elizabeth Johnson | Counselor | 976 Se Evergreen Dr, Chehalis, WA 98532-3110 | 2008-04-30 |
| 1740471911 | Tera Lee Stickley | Counselor | 2428 West Reynolds Ave, Chehalis, WA 98532 | 2007-08-05 |
| 1932323722 | James L. Hunt | Counselor | 243 Us Highway 12, Chehalis, WA 98532-8404 | 2007-04-12 |
| 1467586461 | Kimberly S Carlson | Counselor | 34 Ne Boistfort St Ste 101, Chehalis, WA 98532-2600 | 2007-03-14 |
| Find all providers in CHEHALIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.