Malynda Clark

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6236 Airpark Dr Ste a
Chattanooga, TN 37421-2988

Phone

(423) 954-8867

NPI assigned

Sep 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1093118390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6236 AIRPARK DR STE A",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6236 AIRPARK DR STE A",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212988",
            "telephone_number": "423-954-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MALYNDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Bradford Clark, MS
• Joan Carol Clark, CCC-SLP
• Kristin Clark, SLP-CCC
• Kristin C Clark, RPA
• Lennette Clark, RN
• Robert Joseph Clark, DDS
• Tori Clark, AMFT
• Claire M Clarke, M.A.
• Eric Peter Clarke, MD
• Morgan Lee Clarkson, APRN, FNP-C

• Mental Health Counselor in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Mental Health Counselor in Tennessee

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