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Carly A Clark, PSS
Peer Specialist in Gresham, Oregon
NPI 1689375529

Carly A Clark is a Peer Specialist based in Portland, OR. Carly A Clark practices in Gresham, OR and has the professional credentials of PSS. The NPI Number for Carly A Clark is 1689375529 and holds a License No. (Oregon).

The current practice location address for Carly A Clark is 620 Ne 2Nd St, Gresham, OR and can be reached out via phone at 971-274-3757. You can also correspond with Carly A Clark through the mailing address at 1776 SW MADISON ST, PORTLAND, OR - 97205-1715 (mailing address contact number: 503-224-1044).

Location: 620 Ne 2Nd St, Gresham, OR, 97205-1715
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689375529
Provider Name
Carly A Clark
Credential
PSS
Provider Entity Type
Individual
Gender
Female
Address
620 Ne 2Nd St, Gresham, OR, 97205-1715
Phone Number
971-274-3757
Fax Number
Provider Enumeration Date
03/16/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
620 Ne 2Nd St
City
Gresham
State
Oregon
Zip
97030-7514
Phone Number
971-274-3757
Fax Number
person
Provider Business Mailing Address Details
Address
1776 Sw Madison St
City
Portland
State
Oregon
Zip
97205-1715
Phone Number
503-224-1044
Fax Number
503-621-2235
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Behavior Technician
Speciality
-
Taxonomy
106S00000X
License No.
THW000107924 (Oregon)
Definition
The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Washington)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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