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KELLY S. CLARK LCDCII
NPI 1730690967
Counselor - Addiction (Substance Use Disorder) in Ironton, OH

Active since October 16, 2017
700 PARK AVE, IRONTON, OH 45638(740) 532-1613(740) 532-1715 Get Directions Write a Review

NPPES record last updated: September 7, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 7, 2018, May 2, 2018, Oct 16, 2017 (3 updates tracked since 2017).

About Kelly S. Clark Lcdcii NPPES

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

KELLY S. CLARK LCDCII (NPI 1730690967) is an individual addiction (substance use disorder) provider in Ironton, Ohio, licensed in Ohio (LCDCII.161468) and active in the NPI registry since October 2017.

NPPES Registry Identity

NPI1730690967
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELLY S. CLARKCredential: LCDCII
Location Address700 PARK AVEIronton, OH 45638
Mailing AddressPo Box 108Ironton, OH 45638-0108 · (740) 532-1613 · Fax (740) 532-1715
Phone(740) 532-1613
Fax(740) 532-1715
Sole ProprietorNo
Enumeration DateOctober 16, 2017
Last NPPES UpdateSeptember 7, 20183 updates tracked since enumeration
✔ NPI 1730690967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · LCDCII.161468
700 PARK AVE, Ironton, OH 45638
Open in Google Maps ↗

Other Identifiers 1

Medicaid0274174OH

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.

MASON EASTHAM LCDCII
Counselor (Addiction (Substance Use Disorder))
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613
MICKEY A BABCOCK CDCA
Case Manager/Care Coordinator
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613
ROBERT CROCKREL QMHS, CMS
Case Manager/Care Coordinator
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613
ZACHERY HENRY CDCA
Case Manager/Care Coordinator
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613
AUDRA MARTIN CDCA
Counselor (Addiction (Substance Use Disorder))
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613
AMANDA S RANDOLPH CDCA
Case Manager/Care Coordinator
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613
SARAH BRADLEY LSW
Social Worker
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613
KATRINKA MERICAL CDCA, QMHS
Counselor (Addiction (Substance Use Disorder))
700 PARK AVE
IRONTON, OH 45638
Lawrence County (740) 532-1613

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 1730690967. It was assigned to this individual provider in the NPPES registry on October 16, 2017.

Where is Kelly Clark located?

Kelly Clark practices at 700 Park Ave, Ironton, OH 45638. The listed phone number is (740) 532-1613.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on September 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.