KIMBRLEY D CLARK (NPI# 1770995961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770995961 |
| Entity Type | Individual |
| Full Name | KIMBRLEY D CLARK |
| Credential | LICDC-CS |
| Practice Address |
2057 S. Avon-belden Rd Grafton OH 44044 |
| Mailing Address |
41821 Whitney Rd Lagrange OH 44050-9458 |
| Practice Telephone | 4407481049 |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2014-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
121985 | OH | Behavioral Health & Social Service Providers |
| Street Address |
2057 S. AVON-BELDEN RD |
| City | GRAFTON |
| State | OH |
| Zip Code | 44044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568918118 | Ann Motylewski | Social Worker | 2075 South Avon Beldon Blvd, Grafton, OH 44044 | 2016-09-01 |
| 1649396219 | Cynthia Kay Chrisulis | Licensed Practical Nurse | 1028 Center St, Grafton, OH 44044 | 2007-03-22 |
| 1649334970 | Grafton Township Trustees | Ambulance | 17109 Avon Belden Road, Grafton, OH 44044 | 2006-12-21 |
| 1528091667 | Eaton Township Ttee | Ambulance | 35955 E Royalton Rd, Grafton, OH 44044 | 2006-07-09 |
| 1366440778 | Firas Seffo | Family Medicine | Lake Hospital Systems East, Painesville, OH 44044 | 2005-07-09 |
| 1790909497 | Sarah Ann-marie Boone | Pharmacist | 479 Main St, Grafton, OH 44044 | 2007-04-12 |
| 1780700575 | Nelly J Ruebensaal | Pharmacist | 479 Main Street, Grafton, OH 44044 | 2007-03-22 |
| 1447778188 | Sarah Noel Stanton | Speech-Language Pathologist | 13080 Durkee Rd, Grafton, OH 44044-1122 | 2017-09-01 |
| 1023421112 | Ann Marie Spice | Speech-Language Pathologist | 13070 Durkee Rd, Grafton, OH 44044-1122 | 2014-06-05 |
| 1992120547 | Patricia Prasen | Speech-Language Pathologist | 13050 Durkee Rd, Grafton, OH 44044-1122 | 2014-02-19 |
| Find all providers in zip 44044 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205320462 | Colleen Lynn Kasten | Counselor | 1971 Washington St Ste 200, Grafton, WI 53024-2125 | 2018-06-20 |
| 1104216969 | Daniel Obrien | Counselor | 35645 State Route 303, Grafton, OH 44044-9660 | 2015-02-02 |
| 1366726978 | Janet Resteghini Sullivan | Counselor | 39 Lower Meadow Rd, Grafton, NH 03240-3410 | 2011-09-30 |
| 1124318738 | Quinndui/mip/counseling | Counselor | 47 West 6th Street, Grafton, ND 58237-8704 | 2011-04-15 |
| 1679635973 | Michael Anthony Bryan | Counselor | 728 Hill Avenue, Grafton, ND 58237 | 2006-12-14 |
| 1548870702 | Janet Mcdaniel | Counselor | 1 Hospital Plz, Grafton, WV 26354-1283 | 2020-08-03 |
| 1679081426 | Jesslyn L Chiarello | Counselor | 1971 Washington St, Grafton, WI 53024-2122 | 2018-01-15 |
| 1891231999 | Elizabeth Jane Grant | Counselor | 1971 Washington St, Suite 200, Grafton, WI 53024-2122 | 2017-01-12 |
| 1871948786 | Therese Ward | Counselor | 2075 Avon Belden Rd, Grafton, OH 44044-9805 | 2016-04-28 |
| 1558762641 | Jeffrey J Jerabek | Counselor | 2500 Avon Belden Rd, Grafton, OH 44044-9802 | 2014-09-09 |
| Find all providers in GRAFTON | ||||
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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.