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KELLY CLARK BS, CADC I
NPI 1861796641
Counselor - Addiction (Substance Use Disorder) in Gresham, OR

Active since January 07, 2011
400 NE 7TH ST, GRESHAM, OR 97030(503) 661-5455(503) 661-4959 Get Directions Write a Review

NPPES record last updated: January 7, 2011. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Kelly Clark Bs, Cadc I NPPES

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

KELLY CLARK BS, CADC I (NPI 1861796641) is an individual addiction (substance use disorder) provider in Gresham, Oregon and active in the NPI registry since January 2011.

NPPES Registry Identity

NPI1861796641
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELLY CLARKCredential: BS, CADC I
Location Address400 NE 7TH STGresham, OR 97030-5604
Mailing Address400 Ne 7th StGresham, OR 97030-5604 · (503) 661-5455 · Fax (503) 661-4959
Phone(503) 661-5455
Fax(503) 661-4959
Sole ProprietorNo
Enumeration DateJanuary 7, 2011
✔ NPI 1861796641 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
400 NE 7TH 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.

MATTHEW JOSEPH BARTOLOTTI LSCW
Social Worker (Clinical)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 489-2236
LAURIE ANNE RICKEN B.A.
Counselor (Mental Health)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
RACHEL TOLON
Case Manager/Care Coordinator
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
DONNA MARIE ANDERSON MSW, QMHP
Social Worker (Clinical)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
MARY KATHLEEN BOWER MA
Counselor (Mental Health)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
KEVIN MAHON
Counselor (Mental Health)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455
LAURA A NEUMANN
Counselor (Addiction (Substance Use Disorder))
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 841-4216
ALYSSA WIRTHLIN
Social Worker (Clinical)
400 NE 7TH ST
GRESHAM, OR 97030
Multnomah County (503) 661-5455

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 1861796641. It was assigned to this individual provider in the NPPES registry on January 7, 2011.

Where is Kelly Clark located?

Kelly Clark practices at 400 NE 7th St, Gresham, OR 97030. The listed phone number is (503) 661-5455.

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 January 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.