Katlyn Clark

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Beaver, OH

NPI 1972374536 · NPPES record last updated Jan 12, 2024

Key facts

NPI
1972374536
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
2660 Adams Rd
Beaver, OH 45613-9798
Phone
(740) 947-2364
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

2660 Adams Rd
Beaver, OH 45613-9798

Mailing address

2915 Salem Cave Rd
Beaver, OH 45613-9768

Other providers in Beaver, OH

All providers in Beaver, OH · Addiction (Substance Use Disorder) Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.