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KELLY MARIE CLARK AAC
NPI 1477897916
Peer Specialist in Everett, WA

Active since November 22, 2012
811 MADISON ST, EVERETT, WA 98203(425) 212-4200(425) 212-4201 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 17, 2018, Nov 4, 2017, Aug 24, 2016 (3 updates tracked since 2016).

About Kelly Marie Clark Aac NPPES

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

KELLY MARIE CLARK AAC (NPI 1477897916) is an individual peer specialist in Everett, Washington, licensed in Washington (1477897916) and active in the NPI registry since November 2012. She maintains a secondary practice location in Mount Vernon.

NPPES Registry Identity

NPI1477897916
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKELLY MARIE CLARKCredential: AAC
Location Address811 MADISON STEverett, WA 98203-4543
Mailing Address1100 S 2nd StMount Vernon, WA 98273-4209 · (360) 419-3500
Phone(425) 212-4200
Fax(425) 212-4201
Sole ProprietorNo
Enumeration DateNovember 22, 2012
Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration
✔ NPI 1477897916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in WA · 1477897916
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
811 MADISON ST, Everett, WA 98203
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Secondary Practice Location 1

Location 11100 S 2nd StMount Vernon, WA 98273-4209 · Phone (360) 419-3500

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.

JANELLE SAVILLE RN
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
ASHLEY DYER
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
BEVERLY J CARMAN SUDP
Counselor (Addiction (Substance Use Disorder))
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
MS. LAKISHA BEARCAT CORDELIA
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
RYAN ERTMAN
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
RENAE MORSE
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 347-3149
NATHAN MARTIN SCHMECK
Counselor
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200
MR. JAMES BYRON HARVEY ED.S, MHP, CMHS
Counselor (Mental Health)
811 MADISON ST
EVERETT, WA 98203
Snohomish County (425) 212-4200

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 1477897916. It was assigned to this individual provider in the NPPES registry on November 22, 2012.

Where is Kelly Clark located?

Kelly Clark practices at 811 Madison St, Everett, WA 98203. The listed phone number is (425) 212-4200.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.