Individual provider Active NPI

Michael Clarke, LMHCA, SUDP

  • Mental Health Counselor
  • Tacoma, WA
National Provider Identifier
1891219267
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3713 Pacific Ave Ste E
Tacoma, WA 98418-7845
Phone
(253) 433-7993
Fax
(253) 540-6886
NPI assigned
Jul 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60917997 WA

Addresses

Primary practice location

3713 Pacific Ave Ste E
Tacoma, WA 98418-7845

Mailing address

3713 Pacific Ave Ste E
Tacoma, WA 98418-7845
Phone (253) 433-7993

Other identifiers 1

IdentifierTypeStateIssuer
2133350MedicaidWA

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
CP60917997WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald City Behavioral Health CurrentSince Jul 10, 2024 Accepting new patients
Pierce County Alliance Past Accepting new patients

Locations

3713 Pacific Ave
Ste E
Tacoma, WA 98418
Phone (253) 301-3865

3713 Pacific Ave
Tacoma, WA 98418
Phone (253) 433-7993

Organizations & group practices 2

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1891219267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 PACIFIC AVE STE E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187845",
            "telephone_number": "253-433-7993",
            "fax_number": "253-540-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3713 PACIFIC AVE STE E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187845",
            "telephone_number": "253-433-7993",
            "fax_number": "253-540-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LMHCA, SUDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-27",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60917997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2133350",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.