Hailey Clark

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C7353 Issued in OR

Practice address

63311 Jamison St
Bend, OR 97703-8288

Phone

(541) 322-7500

Fax

(541) 322-7565

NPI assigned

Nov 6, 2017

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

Enrolled in OR

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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.

• Deschutes County Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bend, OR
  • NPI 1235172180
  Medicare reassignment NPD
• Clark Counseling Services, LLC

  • Mental Health Counselor
  • Bend, OR
  • NPI 1477266435
  NPD Authorized official
• Deschutes County Oregon

  • Addiction (Substance Use Disorder) Counselor
  • Bend, OR
  • NPI 1366656068
  NPD
• Deschutes County Oregon

  • Health Educator
  • Bend, OR
  • NPI 1598323040
  NPD

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1841703428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973390579",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63311 JAMISON ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977038288",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1880 NW Monterey Pines Dr Unit 7",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977036744",
            "country_code": "US",
            "telephone_number": "541-896-1317",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 NW 27th St",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973305223",
            "country_code": "US",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-6186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "HAILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C7353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Clark, M.D.
• Dedra Clark
• Desi Clark
• Emily Clark
• Erin Clark, M.A., LPC, BCBA
• Jacquelyn J Clark, MS, CADC II, LPC
• Katelyn Clark
• Katrina A Clark, CRM
• Lindsey Johnson Clark, PA-C
• Matthew Ryan Clark, M.D.

• Professional Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.