Tara Lynn Clark, LMHC, LSWAIC, MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61072662 Issued in WA

Practice address

3539 Dianna Way
Wenatchee, WA 98801-9142

Phone

(509) 334-7123

NPI assigned

Oct 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1376853762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N WENATCHEE AVE STE H",
            "address_2": "#330",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011599",
            "telephone_number": "509-334-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3539 DIANNA WAY",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988019142",
            "telephone_number": "509-334-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "LMHC, LSWAIC, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60863365",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61072662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2102809",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Clark, NP
• Brandy Rene Michele Clark
• Julie Clark, PHARMD
• Katrina Ann Clark, LMP
• Peter Clark, M.D.
• Travis M Clark, MD
• Lisa Clausen, IBCLC
• Vincent Daniel Clawson, LMT
• Melissa Clem, MC60344091
• Cloie Clemans, BCBA

• Mental Health Counselor in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.