Katie Johnson Clark, MA, LPC, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3201 Issued in OR

Practice address

416 NE Dallas St Ste 208
Camas, WA 98607-2189

Phone

(503) 781-1997

Fax

(503) 200-1138

NPI assigned

Aug 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katharine Johnson Clark Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1104173970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 NE DALLAS ST STE 208",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072189",
            "telephone_number": "503-781-1997",
            "fax_number": "503-200-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 NE DALLAS ST STE 208",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072189",
            "telephone_number": "503-781-1997",
            "fax_number": "503-200-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATIE",
        "middle_name": "JOHNSON",
        "credential": "MA, LPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-10",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3201",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61095149",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHARINE",
            "last_name": "CLARK",
            "middle_name": "JOHNSON",
            "credential": "MA, LPC, LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Camas, WA
• Providers in Camas, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.