Active NPI
Karcie Wyatt-Clark, PLPC
- Professional Counselor
- Moberly, MO
National Provider Identifier
1710595236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2019037062
- Practice address
- 224 N Williams St
Moberly, MO 65270-1534 - Phone
- (660) 236-2818
- NPI assigned
- Jul 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2019037062 | MO | Primary |
Addresses
Primary practice location
224 N Williams St
Moberly, MO 65270-1534
Mailing address
224 N Williams St
Moberly, MO 65270-1534
Phone (660) 414-6311
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2019037062 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coyote Hill | Professional | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709769600000",
"number": "1710595236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 N WILLIAMS ST",
"city": "MOBERLY",
"state": "MO",
"postal_code": "652701534",
"telephone_number": "660-414-6311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 N WILLIAMS ST",
"city": "MOBERLY",
"state": "MO",
"postal_code": "652701534",
"telephone_number": "660-236-2818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT-CLARK",
"first_name": "KARCIE",
"credential": "PLPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-21",
"last_updated": "2024-03-07",
"certification_date": "2024-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2019037062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moberly, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.