Charles Michael Clark II, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6314 19TH St W Ste 7
Fircrest, WA 98466-6223

Phone

(253) 201-6070

NPI assigned

Sep 14, 2015

Last updated

Mar 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seeds of Growth

  • Adult Mental Health Clinic/Center
  • University Place, WA
  • NPI 1043779614
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1043688583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 PACIFIC ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994244",
            "telephone_number": "253-201-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 19TH ST W STE 7",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666223",
            "telephone_number": "253-201-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_suffix": "II",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Howard Camm, DMD
• Aaron Cheng, DC
• Stuart-Shea Chick
• Child Psychology Testing Services PLLC
• Sophia Christensen
• Cognitive Growth Mental Health
• Skylar Suzanne Cole
• Lea NMN Conrad, RN
• Cost Less Pharmacy and Wellness LLC
• Cost Less Prescriptions Fircrest Inc (Cost Less Prescriptions)

• Mental Health Counselor in Fircrest, WA
• Providers in Fircrest, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.