Tana L Clarke, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04890 Issued in MD

Practice address

877 Baltimore Annapolis Blvd Ste 202
Severna Park, MD 21146-4716

Phone

(410) 684-3806

Fax

(410) 821-8042

NPI assigned

Oct 27, 2010

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: waypointwellnesscenter.tanaclarke@150898.advancedmd-direct.com

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.

• Waypoint Wellness Center, LLC

  • Psychologist
  • Annapolis, MD
  • NPI 1437548237
  NPD
• Arundel Mental Health Professionals L.C.

  dba LifeStance Health

  • Clinical Psychologist
  • Arnold, MD
  • NPI 1073649521
  NPD (past)

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1053611749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 BALTIMORE ANNAPOLIS BLVD STE 202",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464716",
            "telephone_number": "410-684-3806",
            "fax_number": "410-421-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 BALTIMORE ANNAPOLIS BLVD STE 202",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464716",
            "telephone_number": "410-684-3806",
            "fax_number": "410-821-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "TANA",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Marie Whitman Christiano
• Cisco Center Foundation, Inc.
• Alison Clark, RBT
• Haley Ann Clark, LCMFT
• Courtney Nicole Clarke, DPT
• Taylor Clayton, RBT
• Clear Mind Counseling LLC
• Sharmila Rose Clee
• Marilyn Clements, P.T.
• Lindsay D Clendaniel, PH.D.

• Clinical Psychologist in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.