MS. KIMBERLY SUE CLARK (NPI# 1508210915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508210915 |
| Entity Type | Individual |
| Full Name | MS. KIMBERLY SUE CLARK |
| Credential | QMHA/ QMHP INTERN |
| Practice Address |
1741 Austin St Klamath Falls OR 97603-4621 |
| Practice Telephone | 5418516156 |
| Mailing Telephone | 5418516156 |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2020-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 1114058898 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2545 N Eldorado Ave, Klamath Falls, OR 976016423 | 5418833471 | 5418833524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902362452 | Kimberly Michelle Clark | Technician, Other | 2819 Se Brodiaea Ct, Hillsboro, OR 97123-5201 | 2019-02-20 |
| 1780037994 | Kimberly Clark | Nurse Practitioner | 11251 Westwood Ave, Denham Springs, LA 70726-6947 | 2016-07-22 |
| 1053651869 | Kimberly Gail Clark | Hearing Instrument Specialist | 401 Apperson Dr, Salem, VA 24153-7026 | 2013-02-15 |
| 1952660524 | Kimberly Jo Clark | Licensed Practical Nurse | 334 Elmwood Ave, Barberton, OH 44203-1153 | 2012-05-16 |
| 1336421999 | Kimberly D Clark | Speech-Language Pathologist | 1524 Lexington Road, Clovis, NM 88101-6846 | 2011-09-09 |
| 1376878595 | Kimberly Clark | Physical Therapist | 101 S Kraemer Blvd Ste 125, Placentia, CA 92870-6100 | 2009-10-06 |
| 1609050913 | Kimberly Irene Clark | Counselor | 3077 Coolidge Ave, Costa Mesa, CA 92626-2809 | 2007-12-21 |
| 1053591875 | Kimberly Ann Clark | Counselor | 1516 S Boston Ave, Suite 100, Tulsa, OK 74119-4003 | 2007-11-08 |
| 1841400868 | Kimberly Clark | Social Worker | 4350 Woodland Ave, Jackson, MS 39206-3955 | 2007-05-22 |
| 1902900293 | Kimberly A Clark | Physical Therapist | 614 Monkton Rd, Bristol, VT 05443-5392 | 2006-09-08 |
| Street Address |
1741 AUSTIN ST |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97603-4621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043231210 | Steven R Shirts | Specialist | 1741 Austin St, Klamath Falls, OR 97603-4621 | 2006-07-22 |
| 1164052643 | Trava Sanders | Marriage & Family Therapist | 1741 Austin St, Klamath Falls, OR 97603-4621 | 2020-01-23 |
| 1063070779 | Klamath Falls Christian Counseling | Counselor | 1741 Austin St, Klamath Falls, OR 97603-4621 | 2019-05-29 |
| 1134570005 | Mark Mcclure | Counselor | 1741 Austin St, Klamath Falls, OR 97603 | 2016-06-22 |
| 1538371661 | Steven R. Shirts, Md PC | Clinic/Center | 1741 Austin St, Klamath Falls, OR 97603-4621 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790323699 | Mike Hampson | Counselor | 3203 Vandenberg Road, Klamath Falls, OR 97603 | 2019-12-11 |
| 1356858369 | Scott Richardson | Community Based Residential Treatment Facility, Mental Illness | 3934 Rio Vista Way, Klamath Falls, OR 97603 | 2017-12-29 |
| 1720518392 | Maile Kalus | Counselor | 3647 Or-39, Klamath Falls, OR 97603 | 2017-06-15 |
| 1174067201 | Amber Wu | Audiologist | 4036 S 6th St Ste 3, Klamath Falls, OR 97603 | 2016-12-08 |
| 1568870681 | Nathan William Bailey | Dentist | 2301 Mountain View Blvd, Suite D, Klamath Falls, OR 97603 | 2014-08-01 |
| 1376987784 | Janice Marie Heiney | Denturist | 2607 Crosby Ave, Klamath Falls, OR 97603 | 2013-04-29 |
| 1083958011 | John W Cooper | Denturist | 3949 Shasta Way, Klamath Falls, OR 97603 | 2012-11-15 |
| 1205137742 | Robert Knight | Community Health Worker | 3314 Vandenburg Rd., Klamath Falls, OR 97603 | 2010-11-16 |
| 1841526431 | Tim R Jones | Counselor | 3949 South 6th St, Klamath Falls, OR 97603 | 2009-11-02 |
| 1316135833 | Ernest Thompson O'neal | Emergency Medicine | 211 Arnold Ave. Ste 15, Klamath Falls, OR 97603 | 2007-10-10 |
| Find all providers in zip 97603 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013522663 | Red Is The Road To Wellness (rrw) | Counselor | 3206 Onyx Ave, Klamath Falls, OR 97603-7279 | 2020-09-10 |
| 1790323699 | Mike Hampson | Counselor | 3203 Vandenberg Road, Klamath Falls, OR 97603 | 2019-12-11 |
| 1720518392 | Maile Kalus | Counselor | 3647 Or-39, Klamath Falls, OR 97603 | 2017-06-15 |
| 1588115364 | James Leroy Yahne | Counselor | 5728 S 6th St Ste C, Klamath Falls, OR 97603-5108 | 2016-10-17 |
| 1598160814 | Christopher S. Turner | Counselor | 635 Main St., Klamath Falls, OR 97601 | 2014-10-29 |
| 1316238322 | Joni L. Townsend | Counselor | 121 Iowa St, Klamath Falls, OR 97601 | 2011-04-25 |
| 1982901120 | Sonja Ann Wilder | Counselor | 3647 Highway 39, Klamath Falls, OR 97603-2612 | 2011-02-24 |
| 1154633378 | Lisa Duvall-baker | Counselor | 2555 Main St, Klamath Falls, OR 97601-2723 | 2010-07-02 |
| 1619208337 | Derwin Decker | Counselor | 3949 South 6th Street, Klamath Falls, OR 97603-4746 | 2010-01-20 |
| 1538496518 | Inside Out Counseling Sservice | Counselor | 1421 Esplanade Ave, #7, Klamath Falls, OR 97601-5956 | 2009-11-11 |
| Find all providers in KLAMATH FALLS | ||||
| City | KLAMATH FALLS |
| Zip Code | 97603 |
Please comment or provide details below to improve the information on MS. KIMBERLY SUE CLARK.
| 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.