Katherine Audrey Clark, MA, LMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH17084 Issued in FL

Practice address

3502 Henderson Blvd Ste 218
Tampa, FL 33609-3970

Phone

(727) 537-0752

NPI assigned

Apr 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Audrey Therapy, P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tampa, FL
  • NPI 1376138768
  NPD Authorized official

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

{
    "created_epoch": "1587859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1285254672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 HENDERSON BLVD STE 218",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093970",
            "telephone_number": "727-537-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 HENDERSON BLVD STE 218",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093970",
            "telephone_number": "727-537-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHERINE",
        "middle_name": "AUDREY",
        "credential": "MA, LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-26",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenda S. Clark, LCSW
• Jamie L. Clark, OTR/L
• Kailey Clark, ARNP-C
• Kali Amara Clark, FNC-C
• Karen K. Clark, M.D.
• Kimberly Clark
• Lauren Clark, MD
• Leah Diane Clark, ARNP
• Margaret Clark, LCSW
• Matthew Clark

• Mental Health Counselor in Tampa, FL
• Providers in Tampa, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.