Kimberly Clark

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3795 Issued in MN

Practice address

16016 233Rd St
Little Falls, MN 56345-5583

Phone

(320) 632-5524

Fax

(888) 991-2741

NPI assigned

Apr 6, 2023

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• True Balance LTD

  • Multi-Specialty Clinic/Center
  • Little Falls, MN
  • NPI 1205025442
  NPD

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1740975846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16016 233RD ST",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563455583",
            "telephone_number": "320-632-5524",
            "fax_number": "888-991-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16016 233RD ST",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563455583",
            "telephone_number": "320-632-5524",
            "fax_number": "888-991-2741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Krays Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Cold Spring",
            "state": "MN",
            "postal_code": "563204563",
            "country_code": "US",
            "telephone_number": "320-632-5524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "3795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Carpenter, R.P.A.-C.
• Paul Carpenter, DPT
• Nicole Ann Casey, DDS
• Claudia Ceraceanu Petcu, MSW
• Kayla Ann Christopherson
• Kay Coapstick, LPT
• Coborns Inc (Coborn's LTC Pharmacy #2006)
• Coborns Inc (Coborns Pharmacy #2006)
• Noel David Collis, M.D.
• Zachary Steven Conklin, DDS

• Professional Counselor in Little Falls, MN
• Providers in Little Falls, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.