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CARLY A CLARK PSS
NPI 1689375529
Peer Specialist in Gresham, OR

Active since March 16, 2023
620 NE 2ND ST, GRESHAM, OR 97030(971) 274-3757 Get Directions Write a Review

NPPES record last updated: March 16, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Carly A Clark Pss NPPES

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

CARLY A CLARK PSS (NPI 1689375529) is an individual peer specialist in Gresham, Oregon, licensed in Oregon (THW000107924) and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1689375529
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameCARLY A CLARKCredential: PSS
Location Address620 NE 2ND STGresham, OR 97030-7514
Mailing Address1776 Sw Madison StPortland, OR 97205-1715 · (503) 224-1044 · Fax (503) 621-2235
Phone(971) 274-3757
Sole ProprietorNo
Enumeration DateMarch 16, 2023
NPPES CertifiedMarch 16, 2023
✔ NPI 1689375529 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 OR · THW000107924
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 ListedBehavior TechnicianTaxonomy 106S00000X
620 NE 2ND ST, Gresham, OR 97030
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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.

KATHY A LITVIN CSWA/QMHP-C
Counselor (Mental Health)
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757
MISS ELIZABETH L VALADEZ CRM/PSS
Counselor (Addiction (Substance Use Disorder))
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757
CHRISTINA H COLLIER QMHA-I
Counselor (Mental Health)
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757
JESSICA A TRAILER QMHA-I
Counselor (Mental Health)
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757
DANIELLE CURTIS CRM-II CADC-I QMHA-R
Counselor (Addiction (Substance Use Disorder))
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757
ALBIE M LEMOS CADC-R/CSWA
Social Worker
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757
JUDITH YADIRA BRACAMONTES QMHA-R
Counselor (Mental Health)
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757
DUANE W KOWALSKI CRM/PSS
Counselor (Addiction (Substance Use Disorder))
620 NE 2ND ST
GRESHAM, OR 97030
Multnomah County (971) 274-3757

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 Carly Clark's NPI number?

The NPI number for Carly Clark is 1689375529. It was assigned to this individual provider in the NPPES registry on March 16, 2023.

Where is Carly Clark located?

Carly Clark practices at 620 NE 2nd St, Gresham, OR 97030. The listed phone number is (971) 274-3757.

What is Carly 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 Carly Clark was last updated on March 16, 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.