Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1508210915 Individual Practitioner Female Practitioner

Kimberly Sue Clark , QMHP

Counselor • Klamath Falls, OR

Telehealth Available

Professional Overview & Biography Verified Profile Summary

Kimberly Clark, QMHP is a certified Counselor practicing in Klamath Falls, OR. With approximately 6 years of clinical experience since completing medical education in 2020, Kimberly Clark delivers high-quality medical care to the local community at 905 MAIN ST STE 512.

Kimberly Clark does not directly accept Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Practice Location & Contact Primary Location

Practice Address

905 Main St Ste 512

Klamath Falls, OR 976016062

Telephone 5415919392
Fax 5418330934
Associated Practice Facility / Clinic
🏢 Klamath Counseling Services Facility NPI 1063070779

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

Not Specified

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Klamath Falls, OR

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -0.5 yrs vs City Avg
City Avg: 6.5 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
89 Specialists

Practicing in Klamath Falls, OR (4551 Statewide)

Telehealth Adoption Rate
1.1% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (6 Years) 6 Yrs
Klamath Falls Specialty Average (6.5 Years) 6.5 Yrs

Medical Specialties & State Licenses

CMS Verified: 2023-03-14
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License OR R6418

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OR 17-04-02

Definition to come...

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1114058898 (OR)

Secondary Practice Locations

1741 Austin St

Klamath Falls, OR 976034621

Phone: 5418516156

2545 N Eldorado Ave

Klamath Falls, OR 976016423

Phone: 5418833471

Practice Associates & Co-Workers

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

1 Associated Practitioners
Marena Hughes , LMFT

Marriage & Family Therapist

NPI 1598319089

Licensed Marriage and Family Therapist

Career & Practice History Timeline

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

14 Historical Events
📍
Updated Practice Location March 14, 2023

Registered at 905 MAIN ST STE 512, KLAMATH FALLS, OR 976016062 (Tel: 5415919392)

📍
Updated Business Mailing Address March 14, 2023

Registered at 1500 ADDISON ST, KLAMATH FALLS, OR 976012504 (Tel: 5415919392)

👤
Provider Name / Credentials Updated March 14, 2023

Recorded as KIMBERLY CLARK, QMHP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 14, 2023

Counselor (License #17-04-02 in OR)

📍
Updated Practice Location January 24, 2020

Registered at 1741 AUSTIN ST, KLAMATH FALLS, OR 976034621 (Tel: 5418516156)

📍
Updated Business Mailing Address January 24, 2020

Registered at 1741 AUSTIN ST, KLAMATH FALLS, OR 976034621 (Tel: 5418516156)

👤
Provider Name / Credentials Updated January 24, 2020

Recorded as KIMBERLY CLARK, QMHA/ QMHP INTERN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 24, 2020

Counselor

NPI Profile Active April 21, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location April 21, 2016

Registered at 2545 N ELDORADO AVE, KLAMATH FALLS, OR 976016423 (Tel: 5418833471)

📍
Updated Business Mailing Address April 21, 2016

Registered at 2545 N ELDORADO AVE, KLAMATH FALLS, OR 976016423 (Tel: 5418833471)

👤
Provider Name / Credentials Updated April 21, 2016

Recorded as KIMBERLY CLARK, QMHA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 21, 2016

Counselor

🟢
Initial NPI Registration & Enumeration April 21, 2016

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: 1508210915
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 21, 2016
Last Update: March 14, 2023
Sole Proprietor: No

Mailing Address

1500 Addison St

Klamath Falls, OR 976012504

Phone: 5415919392

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.