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Kathryn Anne Clark , MC, LPC

Counselor - Professional β€’ Gresham, OR

Active NPI 1821434317 Individual Practitioner Female Practitioner Accepts Medicare assignment Telehealth (some services)
Practice location in NPPES

1700 Nw Civic Dr Ste 310
Gresham, OR 970303774

Call 5036668832 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1700 Nw Civic Dr Ste 310

Gresham, OR 970303774

Telephone 5036668832
Organization at the Same NPPES Address or Phone
Western Psychological And Counseling Services Pc Facility NPI 1497179212

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Western Psychological And Counseling Services Llc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2008

Years since graduation

18 years (graduated 2008)

CMS Doctors and Clinicians data list 2008 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2013

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

What this does not show: Telehealth (some services)

It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Kathryn Clark has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Kathryn Clark as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Gresham and Oregon

35 active clinicians are listed under Counselor - Professional with a practice address in Gresham, OR (2,559 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gresham

2.9% of these 35 clinicians have the CMS telehealth indicator.

11.4% of these 35 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-03-13
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES OR C4913
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - MENTAL HEALTH COUNSELOR

Medicare Enrollment ID

I20250807002934

Enrollment State Jurisdiction

OR

PECOS Control ID

2769980994

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Western Psychological And Counseling Services Llc

1700 Nw Civic Dr, Gresham, OR 970303774

Phone: 5036668832

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
Dr. James Bossmann , MD

Psychiatry & Neurology - Psychiatry

NPI 1255867065

Doctor of Medicine (M.D.)

Myron Falkner , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1598196198

Psychiatric-Mental Health Nurse Practitioner

NPI 1063761716

Doctor of Psychology (Psy.D.)

Jessica Wilkerson , APRN-NP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1376796987

APRNNP

Dr. Peter Wilson , PsyD

Psychologist - Clinical

NPI 1992897490

Doctor of Psychology (Psy.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 13, 2026

Counselor (license number reported to NPPES: OR C4913)

πŸ“
Updated Practice Location March 07, 2024

Registered at 1700 NW CIVIC DR STE 310, GRESHAM, OR 970303774 (Tel: 5036668832)

πŸ“
Updated Business Mailing Address March 07, 2024

Registered at 1700 NW CIVIC DR STE 310, GRESHAM, OR 970303774 (Tel: 5036668832)

πŸ‘€
Provider Name / Credentials Updated March 07, 2024

Recorded as KATHRYN CLARK, MC, LPC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2024

Counselor (license number reported to NPPES: OR C4913)

βœ…
NPI Profile Active May 11, 2013

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 11, 2013

Registered at 3716 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 972121111 (Tel: 5032888066)

πŸ“
Business Mailing Address (Initial Record) May 11, 2013

Registered at 14600 NW CORNELL RD, PORTLAND, OR 972295442

πŸ‘€
Provider Name / Credentials (Initial Record) May 11, 2013

Recorded as KATHRYN CLARK, MC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 11, 2013

Counselor

🟒
Initial NPI Registration & Enumeration May 11, 2013

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1821434317
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 11, 2013
Last Update: March 13, 2026
Sole Proprietor: No

Mailing Address

1700 Nw Civic Dr Ste 310

Gresham, OR 970303774

Phone: 5036668832

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.