NICKLAUS CLARK LPC LMHC NPI 1407251408

NPI Information

NPI: 1407251408
Provider Name: NICKLAUS CLARK, LPC, LMHC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1700 NW CIVIC DR
SUITE 310
GRESHAM, OR
ZIP 97030
Phone: (503) 233-5405
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Nicklaus Clark, LPC, LMHC is a professional counselor in Gresham, OR. Nicklaus Clark, LPC, LMHC NPI is 1407251408. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1700 NW CIVIC DR
SUITE 310
GRESHAM, OR
ZIP 97030-770
Phone: (503) 233-5405

The enumeration date for this NPI number is 11/3/2014 and was last updated on 2/4/2016.

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	LH60497951	WASHINGTON	No
2	101YP2500X	Counselor	Professional	2012024654	MISSOURI	No
3	101YP2500X	Counselor	Professional	C3550	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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