KATIE JOHNSON CLARK (NPI# 1104173970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104173970 |
Entity Type | Individual |
Full Name | KATIE JOHNSON CLARK |
Other Name | KATHARINE JOHNSON |
Credential | MA, LPC |
Practice Address |
5520 Sw Macadam Ave Suite 270 Portland OR 97239-3768 |
Practice Telephone | 5037811997 |
Practice Fax Number | 5032001138 |
Mailing Telephone | 5037811997 |
Enumeration Date | 2012-08-10 |
Last Update Date | 2016-12-15 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
Y | 101YP2500X |
Counselor Specialization: Professional |
C3201 | OR | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780225474 | Katie Jane Clark | Specialist | 44 Industrial Way Ste D, Lebanon, OR 97355-4364 | 2019-10-03 |
1912366378 | Katie Clark | Specialist/Technologist | 49383 Sheba Rd, Jacobsburg, OH 43933-9604 | 2016-02-15 |
1831498450 | Katie Clark | Community Health Worker | 10709 N. Division St., Spokane, WA 99221 | 2011-03-22 |
1275195810 | Katie Clark | Case Manager/Care Coordinator | 1601 E 4th Plain Blvd, Vancouver, WA 98661-3713 | 2019-07-03 |
1851870182 | Katie Clark | Counselor | 10 Tsienneto Rd, Derry, NH 03038-1505 | 2018-08-08 |
1417445180 | Katie Clark | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2018-04-27 |
1538661350 | Katie Clark | Registered Nurse | 7 Upper Balcones Rd, Boerne, TX 78006-8546 | 2018-03-07 |
1649704362 | Katie Clark | Counselor | 18 County Center Dr, Oroville, CA 95965-3335 | 2017-04-19 |
1043768104 | Katie Lynn Clark | Registered Nurse | 1791 Alum Creek Drive, Columbus, OH 43207 | 2016-09-19 |
1164760369 | Katie Lynne Clark | Occupational Therapist | 2012 S Jones Blvd, Las Vegas, NV 89146-3151 | 2013-01-22 |
Street Address |
5520 SW MACADAM AVE SUITE 270 |
City | PORTLAND |
State | OR |
Zip Code | 97239-3768 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376526699 | Mark R Weinrott | Psychologist | 5520 Sw Macadam Ave, Suite 260, Portland, OR 97239-3768 | 2005-11-21 |
1689024796 | Jon Hart | Massage Therapist | 5520 Sw Macadam Ave, 230, Portland, OR 97239-3768 | 2016-06-20 |
1124483755 | Rooted Recovery | Community/Behavioral Health | 5520 Sw Macadam Ave, Suite 270, Portland, OR 97239-3768 | 2015-12-26 |
1346665775 | Heather Nielsen | Counselor | 5520 Sw Macadam Ave, Suite 270, Portland, OR 97239 | 2014-02-21 |
1659601961 | Michael Frederick Hohn | Psychologist | 5520 Sw Macadam Ave, Suite 260, Portland, OR 97239-3768 | 2010-01-08 |
1720206055 | Janice I. Volkin | Psychologist | 5520 Sw Macadam Ave, #260, Portland, OR 97239-3768 | 2007-04-23 |
1174624126 | Sharon Lynn Mcallister | Registered Nurse | 5520 Sw Macadam Ave, Suite 190, Portland, OR 97239-3768 | 2006-09-25 |
1447234901 | Susan Elaine Hoffman | Nurse Practitioner | 5520 Sw Macadam Ave, Harbor Square Sw, Suite 260, Portland, OR 97239-3741 | 2005-11-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
Find all providers in zip 97239 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063013373 | Ruth Tessema | Counselor | 2120 Ne 166th Dr, Portland, OR 97230-5558 | 2020-11-03 |
1629675582 | Michelle Robydek | Counselor | 103 Rindle Bluff Dr, Portland, MI 48875-9435 | 2020-10-05 |
1326656240 | Donald Marks | Counselor | 7901 Se Powell Blvd Ste B251, Portland, OR 97206-2314 | 2020-07-16 |
1922624782 | Marc Francis Otto | Counselor | 215 Ne 60th Ave, Portland, OR 97213-3721 | 2020-06-17 |
1013532183 | Monica Grace Vanek | Counselor | 4248 Ne Skidmore St, Portland, OR 97218-1753 | 2020-06-14 |
1427670355 | Leonore Elisabeth Licht-miller | Counselor | 1455 Sw Stephenson St, Portland, OR 97219-8222 | 2020-05-14 |
1821624834 | Kara Pierce | Counselor | 5640 Ne 7th Ave, Portland, OR 97211-3249 | 2020-03-21 |
1932746302 | Lynne Coon Counseling, LLC | Counselor | 1340 Sw Bertha Blvd Ste 202, Portland, OR 97219-2096 | 2019-12-04 |
1912554809 | Genevieve Pritchard | Counselor | 4150 N Williams Ave Apt 409, Portland, OR 97217-2970 | 2019-08-24 |
1407312465 | Jor-el Zajatz | Counselor | 12 Se 14th Ave Ste 105, Portland, OR 97214-1404 | 2019-02-14 |
Find all providers in PORTLAND |
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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.