KATIE JOHNSON CLARK MA LPC NPI 1104173970

NPI Information

NPI: 1104173970
Provider Name: KATIE JOHNSON CLARK, MA, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
5520 SW MACADAM AVE
SUITE 270
PORTLAND, OR
ZIP 97239
Phone: (503) 781-1997
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Katie Johnson Clark, MA, LPC is a professional counselor in Portland, OR. Katie Johnson Clark, MA, LPC NPI is 1104173970. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5520 SW MACADAM AVE
SUITE 270
PORTLAND, OR
ZIP 97239-768
Phone: (503) 781-1997
Fax: (503) 200-1138

The enumeration date for this NPI number is 8/10/2012 and was last updated on 12/15/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	101YP2500X	Counselor	Professional	C3201	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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