Kelsey Nicole Clark, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60878729 Issued in WA

Practice address

4407 N Division St Ste 205
Spokane, WA 99207-1660

Phone

(509) 566-2061

Fax

(509) 566-2061

NPI assigned

Apr 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kelsey N Usher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Charmed Counseling

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1972474021
  NPD (past)
• Charmed Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spokane, WA
  • NPI 1790298610
  NPD (past)

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1205193984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W 30TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992031719",
            "telephone_number": "509-566-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 N DIVISION ST STE 205",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071660",
            "telephone_number": "509-566-2061",
            "fax_number": "509-566-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60243441",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG60679997",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60878729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSING BOARD",
            "identifier": "LF60878729",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "USHER",
            "middle_name": "N",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Clark, LICSW
• John Robert Clark, MD
• Karen Clark, R.PH
• Karly Michelle Clark
• Katie Clark, LMP
• Kendra Rae Clark, OTR/L
• Kerry R Clark, RD
• Lavon Clark, LMFT
• Lincoln Clark, DC
• Lindsay Clark, LICSW

• Marriage & Family Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.