Mark L Clark, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

89-13P Issued in AR

Practice address

2200 Ada Ave Ste 302
Conway, AR 72034-4985

Phone

(501) 932-0352

Fax

(501) 932-0354

NPI assigned

Oct 25, 2006

Last updated

May 10, 2023By the provider in NPPES

Sex

Male

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

Enrolled in AR

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Noydeen Sisters Medical Group and Clinics IncGroup PAC ID 7618260092, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Noydeen Sisters Medical Group & Clinics, Inc

  • Internal Medicine Physician
  • Conway, AR
  • NPI 1285084038
  Medicare reassignment Care Compare group NPD
• Conway Regional Medical Center Inc

  • General Acute Care Hospital
  • Conway, AR
  • NPI 1417024662
  Medicare reassignment NPD
• Conway Regional Medical Center, Inc.

  dba Conway Regional Neuroscience Center

  • Neurology Physician
  • Conway, AR
  • NPI 1255879656
  Medicare reassignment NPD
• Counseling Associates Inc

  • Community/Behavioral Health Agency
  • Russellville, AR
  • NPI 1649381120
  Medicare reassignment NPD
• The Bridgeway, LLC

  • Psychiatric Hospital
  • North Little Rock, AR
  • NPI 1962473306
  Medicare reassignment NPD
• Conway Regional Medical Center Inc

  dba Conway Regional Mobile Health Unit

  • Family Medicine Physician
  • Conway, AR
  • NPI 1043183544
  NPD
• Counseling Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Heber Springs, AR
  • NPI 1144701848
  NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1306921853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 ADA AVE STE 302",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344985",
            "telephone_number": "501-932-0352",
            "fax_number": "501-932-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ADA AVE STE 302",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344985",
            "telephone_number": "501-932-0352",
            "fax_number": "501-932-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "89-13P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaymond Ryan Clark, DC
• John Nicholas Clark, D.D.S.
• Kelly L Clark, PTA
• Leslea Clark, M.S.CCC-SLP
• Madelyn Clark
• Raymond H Clark, MD
• Sarah Grace Clark, DDS
• Candace Marie Clarke-Brown, AT
• Celeste A Clarke, DC
• Chantillee A Clary

• Psychologist in Conway, AR
• Providers in Conway, AR by specialty
• Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.
• 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.

Verify at the official NPI Registry.