MEDICARE: CLARK COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1831052588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARK COUNSELING LLC

Provider Business Mailing Address
First Line	:	513 E 8TH ST
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-6221
Country	:	US
Telephone Number	:	360-460-4071
Fax Number	:

Provider Business Practice Location Address
First Line	:	513 E 8TH ST
Second Line	:
City	:	PORT ANGELES
State	:	WA
Zip	:	98362-6221
Country	:	US
Telephone Number	:	360-460-4071
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	RACHEL LYNN CLARK
Credential	:	LMHC
Telephone Number	:	360-460-4071

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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