Kristen Moriah Clark, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

86790-20 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Apr 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Wisconsin School of Medicine, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1821730623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Pen Bay Medical Center",
            "address_2": "6 Glen Cove Dr",
            "address_purpose": "LOCATION",
            "city": "Rockport",
            "state": "ME",
            "postal_code": "04856",
            "country_code": "US",
            "telephone_number": "207-921-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Maine Behavioral Health",
            "address_2": "24 Miles Center Way",
            "address_purpose": "LOCATION",
            "city": "Damariscotta",
            "state": "ME",
            "postal_code": "04543",
            "country_code": "US",
            "telephone_number": "207-701-4570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "MaineHealth Pediatrics",
            "address_2": "Rockport 15 Anchor Dr., Suite 103",
            "address_purpose": "LOCATION",
            "city": "Rockport",
            "state": "ME",
            "postal_code": "04856",
            "country_code": "US",
            "telephone_number": "207-301-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Maine Behavioral Healthcare",
            "address_2": "12 Union St",
            "address_purpose": "LOCATION",
            "city": "Rockland",
            "state": "ME",
            "postal_code": "04841",
            "country_code": "US",
            "telephone_number": "207-701-4400",
            "fax_number": "207-701-4487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTEN",
        "middle_name": "MORIAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "86790-20",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Cathleen Ciesluk
• Zachary Cigich
• Arianna Dawn Cirincione, LPC-IT
• Theresa D Cirone-Hornickel, NP
• Jay K Clark, LPC, LPCC
• Mary Johanna Clark, DO
• Robert G. Clark, MD
• Marey Susan Clausen-Betz, RN, CSW, BS
• Beth Clements, RN
• Brittany Clements, PA-C

• Psychiatry Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.