Kathleen Pauline Clark, MA, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

31 Lone Holw
Sandy, UT 84092-5500

Phone

(801) 647-5254

NPI assigned

Mar 28, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kathleen Pauline Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Peak Behavioral Consulting

  • Community/Behavioral Health Agency
  • Sandy, UT
  • NPI 1982295325
  NPD Authorized official
• Learning Solutions LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Vernal, UT
  • NPI 1588238133
  NPD (past)

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1497098446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 LONE HOLW",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840925500",
            "telephone_number": "801-647-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 LONE HOLW",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840925500",
            "telephone_number": "801-647-5254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7434 S State St",
            "address_purpose": "LOCATION",
            "city": "Midvale",
            "state": "UT",
            "postal_code": "840472014",
            "country_code": "US",
            "telephone_number": "801-456-9955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATHLEEN",
        "middle_name": "PAULINE",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2023-03-15",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "CLARK",
            "middle_name": "PAULINE",
            "credential": "BCBA, LBA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Claritas Vision Care P.C.
• Clark Dental Group PLLC
• Bryan A Clark, PA-C
• Desiree Deon Clark, PA-C
• Gary K. Clark, DMD
• Stanley Corbin Clark, MD
• Hosanna Clay, MSN, APRN, FNP-C
• David N. Clayton, M.D., F.A.C.S.
• Paul N Clayton, MD
• Clearview Counseling & Assessment Inc

• Behavior Analyst in Sandy, UT
• Providers in Sandy, UT by specialty
• Behavior Analyst in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.