Mellisa A Clark

Primary specialty

CounselorTaxonomy code 101Y00000X

License

MC60309925 Issued in WA

Practice address

1019 Pacific Ave Ste 1022
Tacoma, WA 98402-4491

Phone

(253) 495-9707

NPI assigned

Apr 20, 2013

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

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.

• Transcending Connection Counseling & Wellness

  • Mental Health Counselor
  • Tacoma, WA
  • NPI 1770207466
  NPD Authorized official

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

{
    "created_epoch": "1366416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1376987370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S OXFORD ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651832",
            "telephone_number": "253-495-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE STE 1022",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024491",
            "telephone_number": "253-495-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MELLISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-20",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "MC60309925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Ann Clark, RN
• Lekeisha Clark
• Lisa M Clark, LMP
• Lynn A Clark, ARNP
• Lynne Patricia Clark, MD
• Michael E Clark, MD
• Michelle Clark, D.O.
• Michelle Annette Clark, LMP
• Nicholas Clark, DO
• Sheila M Clark

• Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.