Shelia Clark

Individual provider Active NPI Mental Health Counselor · Prineville, OR

NPI 1003372269 · NPPES record last updated Apr 19, 2021

Key facts

NPI
1003372269
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1103 NE Elm St
Prineville, OR 97754-1664
Phone
(541) 323-5330
Fax
(541) 447-1121
NPI assigned
Feb 13, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

1103 NE Elm St
Prineville, OR 97754-1664

Mailing address

1103 NE Elm St
Prineville, OR 97754-1664
Phone (541) 233-3203

Other names

  • Shelia Clemens Former name

Other providers in Prineville, OR

All providers in Prineville, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.