Thomas R Clark, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301001244 Issued in MI

Practice address

41820 6 Mile Rd
Suite 104
Northville, MI 48168-2763

Phone

(248) 349-3131

Fax

(248) 349-3232

NPI assigned

Aug 8, 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

Medicare fee-for-service enrollment

Enrolled in MI

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

Group practices

Alpha Psychological Services PCGroup PAC ID 5395749147, 3 clinicians

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.

• Alpha Psychological Services, P.C.

  • Psychologist
  • Northville, MI
  • NPI 1831104678
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407866981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41820 6 MILE RD",
            "address_2": "SUITE 104",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481682763",
            "telephone_number": "248-349-3131",
            "fax_number": "248-349-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41820 6 MILE RD",
            "address_2": "SUITE 104",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481682763",
            "telephone_number": "248-349-3131",
            "fax_number": "248-349-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301001244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Northville
• Paul William Clancy, DDS
• Mary Franzen Clark, ED.D.
• Michael Clark, R.AC.
• Rachel Grace Clark
• Classic Home Care Inc
• Emma Cleason
• Devin Clement
• Jeff Clinansmith
• Anthony Cohen

• Clinical Psychologist in Northville, MI
• Providers in Northville, MI by specialty
• Clinical Psychologist in Michigan

• 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.