Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1902201809 Individual Practitioner Male Practitioner

Keith R Clark , LPCC

Counselor - Professional • Dayton, OH

Professional Overview & Biography Verified Profile Summary

Keith Clark, LPCC is a registered healthcare professional specializing in Counselor - Professional in Dayton, OH. Practice services are available at 601 SOUTH EDWIN C MOSES BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

601 South Edwin C Moses Blvd

Dayton, OH 454173424

Telephone 9377348333
Fax 9372768269
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.3 Yrs
State Avg: 15.9 Yrs
Regional Practice Density
132 Specialists

Practicing in Dayton, OH (6923 Statewide)

Telehealth Adoption Rate
6.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2019-12-11
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OH E.1901518

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License OH C1300707TRNE

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Ashley Hicks , PC

Counselor - Mental Health

NPI 1003177932
Sarah Byram , LPC

Counselor - Mental Health

NPI 1003327503

Licensed Professional Counselor

Jaime Aaron , LPCC

Counselor - Professional

NPI 1003347733

Licensed Professional Clinical Counselor

Alexis Grice

Counselor - Mental Health

NPI 1003749474
Pierre Wright , LCDC II

Counselor - Addiction (Substance Use Disorder)

NPI 1023529526

LCDCII

Alexis Rakovan , QMHS-OMS

Case Manager/Care Coordinator

NPI 1023602901

QMHSOMS

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location December 11, 2019

Registered at 601 SOUTH EDWIN C MOSES BLVD, DAYTON, OH 454173424 (Tel: 9377348333)

📍
Updated Business Mailing Address December 11, 2019

Registered at 601 SOUTH EDWIN C MOSES BLVD, DAYTON, OH 454173424 (Tel: 9377348333)

👤
Provider Name / Credentials Updated December 11, 2019

Recorded as KEITH CLARK, LPCC

NPI Profile Active November 04, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location November 04, 2014

Registered at 280 LOONEY ROAD, SUITE 204, PIQUA, OH 45356 (Tel: 9374407121)

📍
Updated Business Mailing Address November 04, 2014

Registered at 601 S EDWIN C MOSES BLVD, SAMARITAN BEHAVIORAL HEALTH, INC., 4TH FLOOR NW BLDG, DAYTON, OH 454173424 (Tel: 9377348333)

👤
Provider Name / Credentials Updated November 04, 2014

Recorded as KEITH CLARK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 04, 2014

Counselor (License #C1300707TRNE in OH)

🟢
Initial NPI Registration & Enumeration November 04, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902201809
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 04, 2014
Last Update: December 11, 2019
Sole Proprietor: No

Mailing Address

601 South Edwin C Moses Blvd

Dayton, OH 454173424

Phone: 9377348333

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.