Individual provider Active NPI

Katye Rue Clark, LPC

  • Professional Counselor
  • Big Spring, TX
National Provider Identifier
1679092548
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75209 Issued in TX
Practice address
1501 W 11TH PL Ste 104
Big Spring, TX 79720-4122
Phone
(432) 263-0027
Fax
(432) 264-4210
NPI assigned
Sep 12, 2017
Last updated
Sep 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 75209 TX Primary

Addresses

Primary practice location

1501 W 11TH PL Ste 104
Big Spring, TX 79720-4122

Mailing address

409 Runnels St
Big Spring, TX 79720-2529
Phone (432) 264-4228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
75209TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock Regional MHMR Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1679092548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 RUNNELS ST",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797202529",
            "telephone_number": "432-264-4228",
            "fax_number": "432-264-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W 11TH PL STE 104",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797204122",
            "telephone_number": "432-263-0027",
            "fax_number": "432-264-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATYE",
        "middle_name": "RUE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "75209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.