Active NPI
Jennifer P Clark, PSY.D.
- Counselor
- Norman, OK
National Provider Identifier
1194855536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 1039
- Practice address
- 1225 W Main St Ste 102
Norman, OK 73069-6851 - Phone
- (405) 305-6648
- NPI assigned
- Mar 6, 2007
- Last updated
- Feb 11, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1039 | OK | Primary |
Addresses
Primary practice location
1225 W Main St Ste 102
Norman, OK 73069-6851
Mailing address
1225 W Main St Ste 102
Norman, OK 73069-6851
Phone (405) 305-6648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1225 W Main St
Suite 102
Norman, OK 73069-6851
Phone (405) 305-6648
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1039 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Norman, OK
- NPI 1972817781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1194855536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 W MAIN ST STE 102",
"city": "NORMAN",
"state": "OK",
"postal_code": "730696851",
"telephone_number": "405-305-6648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 W MAIN ST STE 102",
"city": "NORMAN",
"state": "OK",
"postal_code": "730696851",
"telephone_number": "405-305-6648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JENNIFER",
"middle_name": "P",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OK",
"license": "1039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.