Provider Demographics
NPI:1801802855
Name:CLARK, DESSYE-DEE M (ARNP, PHD)
Entity type:Individual
Prefix:DR
First Name:DESSYE-DEE
Middle Name:M
Last Name:CLARK
Suffix:
Gender:F
Credentials:ARNP, PHD
Other - Prefix:
Other - First Name:DESSYE-DEE
Other - Middle Name:M
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, PHD
Mailing Address - Street 1:301 W SPRUCE ST
Mailing Address - Street 2:SOUND VIEW COUNSELING & ASSOC. PS INC.
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4107
Mailing Address - Country:US
Mailing Address - Phone:406-541-4436
Mailing Address - Fax:406-541-4437
Practice Address - Street 1:301 W SPRUCE ST
Practice Address - Street 2:SOUND VIEW COUNSELING & ASSOC. PS INC.
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4107
Practice Address - Country:US
Practice Address - Phone:406-541-4436
Practice Address - Fax:406-541-4437
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283297163W00000X
WARN00094578163W00000X
MTRN29998363LP0808X, 364SP0807X, 364SP0809X
WA30002196363LP0808X
WAAP30002196364SP0807X, 364SP0809X
MTNUR-APRN-LIC-99982363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0004304872Medicaid
MT29998OtherAPRN
WA30002196OtherARNP
MT0004304872Medicaid
MTQ25973Medicare UPIN