Kelly Christina Clark, LPC
Individual provider Active NPI Professional Counselor · Midlothian, TX
NPI 1659017200 · NPPES record last updated May 6, 2022
Key facts
- NPI
- 1659017200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 77082 (TX)
- Practice address
- 200 S 14TH St
Midlothian, TX 76065-3358 - Phone
- (214) 412-7629
- NPI assigned
- May 6, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77082 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 77082 | TX | Yes |
Addresses
Primary practice location
200 S 14TH St
Midlothian, TX 76065-3358
Mailing address
3116 Stonehenge LN
Carrollton, TX 75006-5214
Phone (214) 412-7629
Other practice location 1
5831 Spring Hills Dr
Midlothian, TX 76065-5820
Phone (214) 412-7629
Other providers in Midlothian, TX
- Christopher D Schmitt DPM PLLC
- City of Midlothian
- Clark Dental Group
- Debora D Clark
- Gerald L Clark
- Kaitlin Clayton
- Andrea F Colclasure
- Krisette Elizabeth Cole
- Chad Edward Coleman
- Brad Wesley Collins
All providers in Midlothian, TX · Professional Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.