MISS KELLY CLARK
NPI 1942605852
Counselor - Mental Health in Booneville, MS

Q: What is Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1942605852. It was assigned to this individual provider in the NPPES registry on November 4, 2014.

Q: What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on November 4, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since November 04, 2014

2301 E CHAMBERS DR, BOONEVILLE, MS 38829(662) 728-3154 Get Directions Write a Review

NPPES record last updated: November 4, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Miss Kelly Clark NPPES

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

MISS KELLY CLARK (NPI 1942605852) is an individual mental health provider in Booneville, Mississippi, licensed in Mississippi (BS DEGREE) and active in the NPI registry since November 2014.

NPPES Registry Identity

NPI1942605852

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMISS KELLY CLARK

Location Address2301 E CHAMBERS DRBooneville, MS 38829-8903

Mailing Address2301 E Chambers DrBooneville, MS 38829-8903 · (662) 728-3154

Phone(662) 728-3154

Sole ProprietorYes

Enumeration DateNovember 4, 2014

✔ NPI 1942605852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in MS · BS DEGREE

2301 E CHAMBERS DR, Booneville, MS 38829

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Other Providers at the Same Location NPPES

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

MRS. LYDIA JACKSON LOVELL CRNP

Nurse Practitioner (Family)

2301 E CHAMBERS DR
BOONEVILLE, MS 38829

Prentiss County (662) 720-4816

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 1942605852. It was assigned to this individual provider in the NPPES registry on November 4, 2014.

Where is Kelly Clark located?

Kelly Clark practices at 2301 E Chambers Dr, Booneville, MS 38829. The listed phone number is (662) 728-3154.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on November 4, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.