Healthcare Provider Details
I. General information
NPI: 1801802855
Provider Name (Legal Business Name): DESSYE-DEE M CLARK ARNP, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2006
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 W SPRUCE ST SOUND VIEW COUNSELING & ASSOC. PS INC.
MISSOULA MT
59802-4107
US
IV. Provider business mailing address
301 W SPRUCE ST SOUND VIEW COUNSELING & ASSOC. PS INC.
MISSOULA MT
59802-4107
US
V. Phone/Fax
- Phone: 406-541-4436
- Fax: 406-541-4437
- Phone: 406-541-4436
- Fax: 406-541-4437
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | RN29998 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 30002196 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | NUR-APRN-LIC-99982 |
| License Number State | MT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | RN29998 |
| License Number State | MT |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | AP30002196 |
| License Number State | WA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | RN29998 |
| License Number State | MT |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | AP30002196 |
| License Number State | WA |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 283297 |
| License Number State | CA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN00094578 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
