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RUSSELL CLARK
NPI 1659111508
Peer Specialist in Saint Louis, MO

Active since May 29, 2024
3649 MERAMEC ST, SAINT LOUIS, MO 63116(314) 930-9384 Get Directions Write a Review

NPPES record last updated: May 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Russell Clark NPPES

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

RUSSELL CLARK (NPI 1659111508) is an individual peer specialist in Saint Louis, Missouri and active in the NPI registry since May 2024.

NPPES Registry Identity

NPI1659111508
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameRUSSELL CLARK
Location Address3649 MERAMEC STSaint Louis, MO 63116-4411
Mailing Address35 San Marino PkwyFenton, MO 63026-7513
Phone(314) 930-9384
Sole ProprietorNo
Enumeration DateMay 29, 2024
NPPES CertifiedMay 29, 2024
✔ NPI 1659111508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
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 ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedCommunity Health WorkerTaxonomy 172V00000X
3649 MERAMEC ST, Saint Louis, MO 63116
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Other Providers at the Same Location NPPES 9

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

MS. CALLAN HOWTON MPH, CRADC
Counselor (Addiction (Substance Use Disorder))
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384
STEPHANIE PARISI
Peer Specialist
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384
TRENT MONTGOMERY
Peer Specialist
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384
JANET HAMPTON
Peer Specialist
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384
HAVEN RECOVERY HOMES
Substance Abuse Rehabilitation Facility
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384
SAMUEL WITTICH
Case Manager/Care Coordinator
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384
DENARO MACK
Case Manager/Care Coordinator
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384
BRETT MONTGOMERY
Case Manager/Care Coordinator
3649 MERAMEC ST
SAINT LOUIS, MO 63116
St. Louis City (314) 930-9384

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 Russell Clark's NPI number?

The NPI number for Russell Clark is 1659111508. It was assigned to this individual provider in the NPPES registry on May 29, 2024.

Where is Russell Clark located?

Russell Clark practices at 3649 Meramec St, Saint Louis, MO 63116. The listed phone number is (314) 930-9384.

What is Russell 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 Russell Clark was last updated on May 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.