Maxwell Clark
Individual provider Active NPI School Psychologist · Marshall, WI
NPI 1083545107 · NPPES record last updated May 27, 2026
Key facts
- NPI
- 1083545107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 617 Madison St
Marshall, WI 53559-9273 - Phone
- (608) 655-3466
- NPI assigned
- May 27, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JT School Dist 2 Village of Marshall Et Al | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
617 Madison St
Marshall, WI 53559-9273
Mailing address
617 Madison St
Marshall, WI 53559-9273
Other providers in Marshall, WI
- Christy Ann Elaine Bemis
- Emily Brewer
- Cindy Brosig
- Valinda Butson
- Sandra Carmen Canon
- Dane County EMS District No 14
- Nikki Lee Frisch
- Laura Gillis
- Tiffany Chanel Gray
- Kim Lee Hackett
All providers in Marshall, WI · School Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.