Kelli Clark , PRSS
Peer Specialist • Yukon, OK
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kelli Clark has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Kelli Clark, PRSS was a registered Peer Specialist practicing in Yukon, OK. Throughout an active medical career spanning 8 years, Kelli Clark provided care at the practice location at 11729 HACKNEY LN until profile deactivation on 2024-02-21.
Practice Location & Contact Primary Location
11729 Hackney Ln
Yukon, OK 730998130
Specialty Benchmarks & Practice Insights
Comparative analytics for Peer Specialist in Yukon, OK
Practicing in Yukon, OK (5280 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 175T00000X
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Nurse Practitioner - Family
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on February 21, 2024
Recorded as KELLI MADISON, CM, PRSS, BHWC
Health & Wellness Coach (License #4159 in OK)
Registered at 4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 731055108 (Tel: 4054247711)
Registered at 4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 731055108 (Tel: 4054247711)
Recorded as KELLI MADISON, PRSS
Peer Specialist (License #130404 in OK)
NPI status registered as active in NPPES database
Registered at 11729 HACKNEY LN, YUKON, OK 730998130 (Tel: 4059210341)
Registered at 11729 HACKNEY LN, YUKON, OK 730998130 (Tel: 4059219341)
Recorded as KELLI CLARK, PRSS
Peer Specialist
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
11729 Hackney Ln
Yukon, OK 730998130
Phone: 4059219341
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