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Ms. Kimberly Sue Clark, QMHP
Counselor in Klamath Falls, Oregon
NPI 1508210915

Kimberly Sue Clark is a Counselor based in Klamath Falls, OR. Kimberly Sue Clark practices in Klamath Falls, OR and has the professional credentials of QMHP. The NPI Number for Kimberly Sue Clark is 1508210915 and holds a License No. 17-04-02 (Oregon).

The current practice location address for Kimberly Sue Clark is 905 Main St Ste 512, Klamath Falls, OR and can be reached out via phone at 541-591-9392 and via fax at 541-833-0934.

Location: 905 Main St Ste 512, Klamath Falls, OR, 97601-2504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508210915
Provider Name
Kimberly Sue Clark
Credential
QMHP
Provider Entity Type
Individual
Gender
Female
Address
905 Main St Ste 512, Klamath Falls, OR, 97601-2504
Phone Number
541-591-9392
Fax Number
541-833-0934
Provider Enumeration Date
04/21/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1114058898 05 OR
institution
Provider Business Practice Location Address Details
Address
905 Main St Ste 512
City
Klamath Falls
State
Oregon
Zip
97601-6062
Phone Number
541-591-9392
Fax Number
541-833-0934
person
Provider Business Mailing Address Details
Address
905 Main St Ste 512
City
Klamath Falls
State
Oregon
Zip
97601-6062
Phone Number
541-591-9392
Fax Number
541-833-0934
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
R6418 (Oregon)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
17-04-02 (Oregon)
Definition
Definition to come...
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