Active NPI 1104173970 Individual Practitioner Female Practitioner

Katie Johnson Clark , MA, LPC, LMHC

Counselor - Professional • Camas, WA

Professional Overview & Biography Verified Profile Summary

Katie Clark, MA, LPC, LMHC is a registered healthcare professional specializing in Counselor - Professional in Camas, WA. Practice services are available at 416 NE DALLAS ST STE 208 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

416 Ne Dallas St Ste 208

Camas, WA 986072189

Telephone 5037811997

Fax 5032001138

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Camas, WA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 15.2 Yrs

Regional Practice Density

3 Specialists

Practicing in Camas, WA (615 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: 2026-06-26

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OR C3201

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License WA 61095149

Definition to come...

Career & Practice History Timeline

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

13 Historical Events

📍

Updated Practice Location June 26, 2026

Registered at 416 NE DALLAS ST STE 208, CAMAS, WA 986072189 (Tel: 5037811997)

📍

Updated Business Mailing Address June 26, 2026

Registered at 416 NE DALLAS ST STE 208, CAMAS, WA 986072189 (Tel: 5037811997)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 26, 2026

Counselor (License #C3201 in OR)

📍

Updated Practice Location December 01, 2023

Registered at 416 NE DALLAS ST STE 207, CAMAS, WA 986072189 (Tel: 5037811997)

📍

Updated Business Mailing Address December 01, 2023

Registered at 416 NE DALLAS ST STE 207, CAMAS, WA 986072189 (Tel: 5037811997)

👤

Provider Name / Credentials Updated December 01, 2023

Recorded as KATIE CLARK, MA, LPC, LMHC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 01, 2023

Counselor (License #61095149 in WA)

✅

NPI Profile Active December 15, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location December 15, 2016

Registered at 5520 SW MACADAM AVE, SUITE 270, PORTLAND, OR 972393768 (Tel: 5037811997)

📍

Updated Business Mailing Address December 15, 2016

Registered at 5520 SW MACADAM AVE, SUITE 270, PORTLAND, OR 972393768 (Tel: 5037811997)

👤

Provider Name / Credentials Updated December 15, 2016

Recorded as KATIE CLARK, MA, LPC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 15, 2016

Counselor

🟢

Initial NPI Registration & Enumeration August 10, 2012

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: 1104173970

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 10, 2012

Last Update: June 26, 2026

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

416 Ne Dallas St Ste 208

Camas, WA 986072189

Phone: 5037811997

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.