Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1689375529 Individual Practitioner Female Practitioner

Carly A Clark , PSS

Peer Specialist • Gresham, OR

Professional Overview & Biography Verified Profile Summary

Carly Clark, PSS is a registered healthcare professional specializing in Peer Specialist in Gresham, OR. Practice services are available at 620 NE 2ND ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

620 Ne 2nd St

Gresham, OR 970307514

Telephone 9712743757
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Gresham, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
43 Specialists

Practicing in Gresham, OR (3408 Statewide)

Telehealth Adoption Rate
0.0% 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: 2023-03-16
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License OR THW000107924

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.

Behavior Technician

NUCC Taxonomy Code: 106S00000X

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

Practice Associates & Co-Workers

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

40 Associated Practitioners
Kathy Litvin , CSWA, QMHP-C

Counselor - Mental Health

NPI 1003213737

CSWA, QMHPC

Elizabeth Valadez , CRM, PSS

Counselor - Addiction (Substance Use Disorder)

NPI 1013765569
Christina Collier , QMHA-I

Counselor - Mental Health

NPI 1023570397

QMHAI

Jessica Trailer , QMHA-I

Counselor - Mental Health

NPI 1033758479

QMHAI

Danielle Curtis , CRM-II CADC-I QMHA-R

Counselor - Addiction (Substance Use Disorder)

NPI 1063209914

CRMIICADCIQMHAR

NPI 1073060083

CADCR, CSWA

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active March 16, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location March 16, 2023

Registered at 620 NE 2ND ST, GRESHAM, OR 970307514 (Tel: 9712743757)

📍
Updated Business Mailing Address March 16, 2023

Registered at 1776 SW MADISON ST, PORTLAND, OR 972051715 (Tel: 5032241044)

👤
Provider Name / Credentials Updated March 16, 2023

Recorded as CARLY CLARK, PSS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 16, 2023

Behavior Technician

🟢
Initial NPI Registration & Enumeration March 16, 2023

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: 1689375529
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 16, 2023
Last Update: March 16, 2023
Sole Proprietor: No

Mailing Address

1776 Sw Madison St

Portland, OR 972051715

Phone: 5032241044

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.