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KELLY SUSANN CLARK
NPI 1467186767
Counselor - Mental Health in Newport, OR

Active since July 12, 2022
36 SW NYE ST, NEWPORT, OR 97365(541) 265-0445 Get Directions Write a Review

NPPES record last updated: May 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 10, 2023, Jul 12, 2022 (2 updates tracked since 2022).

About Kelly Susann Clark NPPES

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

KELLY SUSANN CLARK (NPI 1467186767) is an individual mental health provider in Newport, Oregon and active in the NPI registry since July 2022. She maintains a secondary practice location in Newport.

NPPES Registry Identity

NPI1467186767
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKELLY SUSANN CLARK
Location Address36 SW NYE STNewport, OR 97365-3821
Mailing Address65070 E Lupine DrRhododendron, OR 97049-9771
Phone(541) 265-0445
Sole ProprietorNo
Enumeration DateJuly 12, 2022
Last NPPES UpdateMay 10, 20232 updates tracked since enumeration
NPPES CertifiedMay 10, 2023
✔ NPI 1467186767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
36 SW NYE ST, Newport, OR 97365
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Other Names 1

Other Name (5)Kelly S Frederick

Secondary Practice Location 1

Location 151 SW Lee StNewport, OR 97365-3823 · Phone (541) 574-5960

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COUNTY OF LINCOLN
Clinic/Center
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (541) 265-0468
MICHAEL HENRY MAHLMAN M. ED
Counselor (Mental Health)
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (541) 265-6611
AMANDA CRYSTAL WILLIAMS CMA
Nurse's Aide
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (154) 126-5046
MRS. LORIE ANN KELLEY NORTON APRN
Nurse Practitioner (Family)
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (541) 265-4947
WILMA SANTIAGO
Community Health Worker
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (541) 265-4947
MARCIA JENNIFER ADAMS M.D.
Family Medicine
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (541) 265-6611
VALERIE D PETERSEN CADCII
Counselor (Addiction (Substance Use Disorder))
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (541) 265-0581
TIFFANY BYERS
Counselor (Mental Health)
36 SW NYE ST
NEWPORT, OR 97365
Lincoln County (541) 265-0412

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 Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1467186767. It was assigned to this individual provider in the NPPES registry on July 12, 2022. The provider is also known as Kelly S Frederick.

Where is Kelly Clark located?

Kelly Clark practices at 36 SW Nye St, Newport, OR 97365. The listed phone number is (541) 265-0445.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on May 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.