Kyra Clark

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7392 Issued in OK

Practice address

3015 E Skelly Dr Ste 103
Tulsa, OK 74105-6344

Phone

(888) 882-0859

NPI assigned

May 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1083093512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 S 73RD EAST AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741459329",
            "telephone_number": "918-613-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E SKELLY DR STE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056344",
            "telephone_number": "888-882-0859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 S 73rd East Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741459329",
            "country_code": "US",
            "telephone_number": "918-613-0250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KYRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "7392",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "7392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Lynn Clark
• Jordan Beverly Paige Clark
• Kayla R Clark, AT
• Kaylea Clark
• Kimberly Ann Clark, MHR
• Laurie C Clark, DO
• Lynetta Clark, LPC
• Michala M Clark
• Richard Clark
• Sacha Dariana Clark, MD DDS

• Professional Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.