Michael Wayne Clark

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

2727 S 3Rd St
Ironton, OH 45638-2760

Phone

(740) 534-2100

NPI assigned

May 15, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/bethesdaservicesllc/r4/

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.

• Bethesda Services LLC

  • Community/Behavioral Health Agency
  • Ironton, OH
  • NPI 1790586444
  NPD (past)
• Bethesda Services LLC

  • Addiction (Substance Use Disorder) Counselor
  • Ironton, OH
  • NPI 1992392005
  NPD (past)

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

{
    "created_epoch": "1778803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1205765351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 S 3RD ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456382760",
            "telephone_number": "740-534-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 S 3RD ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456382760",
            "telephone_number": "740-534-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 4th St E",
            "address_purpose": "LOCATION",
            "city": "South Point",
            "state": "OH",
            "postal_code": "456809113",
            "country_code": "US",
            "telephone_number": "740-534-2100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 E Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430555651",
            "country_code": "US",
            "telephone_number": "740-534-2039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-15",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian J Church, CDCA
• City of Ironton (Ironton city Health Department)
• Elizabeth Ellen Clark, MSW
• Kelly S. Clark, LCDCII
• Mackenzie Clark
• Dafney Clary
• Dottie Clay
• Lora Clay
• Clearview Behavioral Health LLC
• Robert Cleary

• Peer Specialist in Ironton, OH
• Providers in Ironton, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.