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NICOLE ELIZABETH CLARK
NPI 1023513637
Counselor in Portland, OR

Active since March 26, 2018
3650 NE MALLORY AVE APT 309, PORTLAND, OR 97212(971) 331-0422 Get Directions Write a Review

NPPES record last updated: December 4, 2018. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Dec 4, 2018, Mar 26, 2018 (2 updates tracked since 2018).

About Nicole Elizabeth Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE ELIZABETH CLARK (NPI 1023513637) is an individual counselor in Portland, Oregon and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1023513637
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameNICOLE ELIZABETH CLARK
Location Address3650 NE MALLORY AVE APT 309Portland, OR 97212-3086
Mailing Address3650 Ne Mallory Ave Apt 309Portland, OR 97212-3086 · (971) 331-0422
Phone(971) 331-0422
Sole ProprietorNo
Enumeration DateMarch 26, 2018
Last NPPES UpdateDecember 4, 20182 updates tracked since enumeration
✔ NPI 1023513637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3650 NE MALLORY AVE APT 309, Portland, OR 97212
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Clark's NPI number?

The NPI number for Nicole Clark is 1023513637. It was assigned to this individual provider in the NPPES registry on March 26, 2018.

Where is Nicole Clark located?

Nicole Clark practices at 3650 NE Mallory Ave Apt 309, Portland, OR 97212. The listed phone number is (971) 331-0422.

What is Nicole Clark's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Nicole Clark was last updated on December 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.