Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carolyn Clark, QMHA, PSS, CRM, CGAC

Individual provider Mental Health Counselor · NPI 1578341731

Carolyn Clark, QMHA, PSS, CRM, CGAC is a Mental Health Counselor in Medford, Oregon. Licensed in Oregon. Registered with an NPI since 2023.

Licensed in
OR
In the registry since
2023
Specialties on file
2

Practice location Address checks out

200 Beatty St
Medford, OR 97501-5811
Phone: (541) 476-2373
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X · Licence 110022 (OR)
Mental Health Counselor Taxonomy 101YM0800X · Licence 23-QMHA-R-4637 (OR)

Record details

NPI number1578341731
Entity typeIndividual (Type 1)
GenderFemale
Credentials QMHA , PSS , CRM , CGAC
Sole proprietorNo
NPI enumeratedSeptember 19, 2023
Last updated in NPPESJuly 24, 2024
Certification dateJuly 24, 2024

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