Individual provider Active NPI

Chelsea D. Clark, RC

  • Counselor
  • Seattle, WA
National Provider Identifier
1255495826
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LW60051601 Issued in WA
Practice address
325 9TH Ave
Box 359930
Seattle, WA 98104-2420
Phone
(206) 731-3000
NPI assigned
Dec 20, 2006
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LW60051601 WA Primary

Addresses

Primary practice location

325 9TH Ave
Box 359930
Seattle, WA 98104-2420

Mailing address

325 9TH Ave
Box 359750
Seattle, WA 98104-2420
Phone (206) 744-9888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LW60051601WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1255495826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "address_2": "BOX 359750",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042420",
            "telephone_number": "206-744-9888",
            "fax_number": "206-744-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "address_2": "BOX 359930",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042420",
            "telephone_number": "206-731-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHELSEA",
        "middle_name": "D.",
        "credential": "RC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "LW60051601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.