William H Clark, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

35SI00115900 Issued in NJ

Practice address

530 N Maple Ave
Ridgewood, NJ 07450-1610

Phone

(201) 689-8293

Fax

(201) 689-8293

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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 and National Provider Directory roles.

• William H. Clark, PH.D.

  • Clinical Psychologist
  • Ho Ho Kus, NJ
  • NPI 1851984280
  Medicare reassignment NPD Authorized official
• David M Coonrad DC PA

  • Chiropractor
  • Paramus, NJ
  • NPI 1619170636
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366464364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 KENILWORTH RD",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074505201",
            "telephone_number": "201-689-8293",
            "fax_number": "201-689-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501610",
            "telephone_number": "201-689-8293",
            "fax_number": "201-689-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00115900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0184705",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Chung
• Anthony J Cipriano, DMD
• Steven Cipris, D.D.S.
• Kenneth A Citak, MD
• Gayle Clachko, MSW
• Michael Clemente, D.M.D
• Nicole Clemente, DDS
• John Alexander Co, MD
• Margaret Ann Co, MD
• William S. Cobb, M.D.

• Psychologist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.