MS. KIMBERLY SUE CLARK QMHP
NPI 1508210915
Counselor in Klamath Falls, OR

Q: What is Kimberly Clark's NPI number?

The NPI number for Kimberly Clark is 1508210915. It was assigned to this individual provider in the NPPES registry on April 21, 2016. The provider is also known as Kim Dutton Lmft Associate.

Q: What is Kimberly Clark's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kimberly Clark was last updated on March 14, 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.

Active since April 21, 2016PECOS Enrolled

905 MAIN ST STE 512, KLAMATH FALLS, OR 97601(541) 591-9392(541) 833-0934 Get Directions Write a Review

NPPES record last updated: March 14, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 14, 2023, Jan 24, 2020 (2 updates tracked since 2020).

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About Ms. Kimberly Sue Clark Qmhp NPPES

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

MS. KIMBERLY SUE CLARK QMHP (NPI 1508210915) is an individual counselor in Klamath Falls, Oregon, licensed in Oregon (R6418) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1508210915

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameMS. KIMBERLY SUE CLARKCredential: QMHP

Location Address905 MAIN ST STE 512Klamath Falls, OR 97601-6062

Mailing Address1500 Addison StKlamath Falls, OR 97601-2504 · (541) 591-9392 · Fax (541) 833-0934

Phone(541) 591-9392

Fax(541) 833-0934

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateApril 21, 2016

Last NPPES UpdateMarch 14, 20232 updates tracked since enumeration

NPPES CertifiedMarch 14, 2023

✔ NPI 1508210915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in OR · R6418

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 ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 17-04-02 (OR)

905 MAIN ST STE 512, Klamath Falls, OR 97601

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Other Names 1

Former Name (1)Kim Dutton Lmft Associate

Secondary Practice Locations 2

Location 11741 Austin StKlamath Falls, OR 97603-4621 · Phone (541) 851-6156

Location 22545 N Eldorado AveKlamath Falls, OR 97601-6423 · Phone (541) 883-3471 · Fax (541) 883-3524

Other Identifiers 1

Medicaid1114058898OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kimberly Sue Clark Qmhp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5395197198

PECOS Enrollment IDI20240117002555

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

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

KLAMATH COUNSELING SERVICES

Clinic/Center (Mental Health (Including Community Mental Health Center))

905 MAIN ST STE 512
KLAMATH FALLS, OR 97601

Klamath County (541) 671-3740

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 Kimberly Clark's NPI number?

The NPI number for Kimberly Clark is 1508210915. It was assigned to this individual provider in the NPPES registry on April 21, 2016. The provider is also known as Kim Dutton Lmft Associate.

Where is Kimberly Clark located?

Kimberly Clark practices at 905 Main St Ste 512, Klamath Falls, OR 97601. The listed phone number is (541) 591-9392.

What is Kimberly Clark's specialty?

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

Is Kimberly Clark enrolled in Medicare?

Yes. Kimberly Clark is registered in the Medicare PECOS enrollment system.

What insurance does Kimberly Clark accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Kimberly Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimberly Clark was last updated on March 14, 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.