Stephen Clark, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

99-07P Issued in AR

Practice address

10025 W. Markham Street
Ste 210
Little Rock, AR 72205-2178

Phone

(501) 663-4673

Fax

(501) 801-1816

NPI assigned

Nov 1, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/lhsoutheast/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Living Hope Southeast, LLC

  • Mental Health Counselor
  • Monticello, AR
  • NPI 1689877862
  Medicare reassignment NPD
• Delta Counseling Associates Inc

  • Community/Behavioral Health Agency
  • Monticello, AR
  • NPI 1053364612
  NPD (past)
• Senior Resolution Resources, Inc

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1760453914
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1003095415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10025 W. MARKHAM STREET",
            "address_2": "STE 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722052178",
            "telephone_number": "501-663-4673",
            "fax_number": "501-801-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10025 W. MARKHAM STREET",
            "address_2": "STE 210",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722052178",
            "telephone_number": "501-663-4673",
            "fax_number": "501-801-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEPHEN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "99-07P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Clark
• Robert B Clark, MD
• Sally Clark, MD
• Shameka Clark, M.S. CCC-SLP
• Shannon Westmoreland Clark, M.A.P.
• Stuart Alan Clark, L.C.S.W.
• Sue Clark, QBHP
• Vonda Clark, PT
• William Reid Clark, DC
• Jonathan Peter Clarke, LCSW

• Psychologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.