Shawn L Clark, PH.D.
Individual provider Active NPI Clinical Psychologist · Tuskegee, AL
NPI 1184776007 · NPPES record last updated Jul 12, 2007
Key facts
- NPI
- 1184776007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 002809 (GA)
- Practice address
- 2400 Hospital Rd
123
Tuskegee, AL 36083-5001 - Phone
- (334) 727-0550
- Fax
- (334) 725-3262
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002809 | GA | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 002809 | GA | Yes |
Addresses
Primary practice location
2400 Hospital Rd
123
Tuskegee, AL 36083-5001
Mailing address
2400 Hospital Rd
123
Tuskegee, AL 36083-5001
Phone (334) 727-0550
Other providers in Tuskegee, AL
- Central Alabama Veterans Health Care Systems
- Verdelle Glover Chambliss
- Chicken
- CHS Personal Care, LLC
- Ana Hilda Cintron
- Angelia Elaine Clayton
- Sherita Coachman
- Katherine Cofer
- Brittany Coleman
- Xismari Collazo-Colon
All providers in Tuskegee, AL · Clinical Psychologist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2007. 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.