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KEITH R CLARK LPCC
NPI 1902201809
Counselor - Professional in Dayton, OH

Active since November 04, 2014
601 SOUTH EDWIN C MOSES BLVD, DAYTON, OH 45417(937) 734-8333(937) 276-8269 Get Directions Write a Review

NPPES record last updated: December 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Keith R Clark Lpcc NPPES

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

KEITH R CLARK LPCC (NPI 1902201809) is an individual professional provider in Dayton, Ohio, licensed in Ohio (E.1901518) and active in the NPI registry since November 2014.

NPPES Registry Identity

NPI1902201809
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameKEITH R CLARKCredential: LPCC
Location Address601 SOUTH EDWIN C MOSES BLVDDayton, OH 45417-3424
Mailing Address601 South Edwin C Moses BlvdDayton, OH 45417-3424 · (937) 734-8333 · Fax (937) 276-8269
Phone(937) 734-8333
Fax(937) 276-8269
Sole ProprietorNo
Enumeration DateNovember 4, 2014
Last NPPES UpdateDecember 11, 2019
✔ NPI 1902201809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OH · E.1901518
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License C1300707TRNE (OH)
601 SOUTH EDWIN C MOSES BLVD, Dayton, OH 45417
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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.

JAIME AARON LPCC
Counselor (Professional)
601 SOUTH EDWIN C MOSES BLVD, SAMARITAN BEHAVIORAL HEALTH, INC, FIRST FLOOR
DAYTON, OH 45417
Montgomery County (937) 734-8333
ALEXIS RAKOVAN QMHS-OMS
Case Manager/Care Coordinator
601 SOUTH EDWIN C MOSES BLVD
DAYTON, OH 45417
Montgomery County (937) 734-8333
MRS. MONICA L SCHAFER RN
Registered Nurse (Addiction (Substance Use Disorder))
601 SOUTH EDWIN C MOSES BLVD
DAYTON, OH 45417
Montgomery County (937) 734-8333
ROBIN D MYERS RN
Registered Nurse (Psychiatric/Mental Health)
601 SOUTH EDWIN C MOSES BLVD
DAYTON, OH 45417
Montgomery County (937) 734-8333
TERRANCE THOMPSON RN
Registered Nurse
601 SOUTH EDWIN C MOSES BLVD
DAYTON, OH 45417
Montgomery County (937) 734-8333
CONNIE FISCHER RN
Registered Nurse
601 SOUTH EDWIN C MOSES BLVD
DAYTON, OH 45417
Montgomery County (937) 734-8333
TIONNA N TOWLER SWT
Social Worker
601 SOUTH EDWIN C MOSES BLVD
DAYTON, OH 45417
Montgomery County (937) 734-8333
SIDNEY M BECKMAN LSW
Social Worker
601 SOUTH EDWIN C MOSES BLVD
DAYTON, OH 45417
Montgomery County (937) 734-8333

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 Keith Clark's NPI number?

The NPI number for Keith Clark is 1902201809. It was assigned to this individual provider in the NPPES registry on November 4, 2014.

Where is Keith Clark located?

Keith Clark practices at 601 South Edwin C Moses Blvd, Dayton, OH 45417. The listed phone number is (937) 734-8333.

What is Keith Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Keith Clark was last updated on December 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.