Active NPI
Janet Lee Clark, PH.D.
- Psychologist
- Columbus, OH
National Provider Identifier
1427019926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3908
- Practice address
- 3449 E Livingston Ave
Columbus, OH 43227-2220 - Phone
- (614) 231-7255
- Fax
- (614) 855-1170
- NPI assigned
- Apr 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3908 | OH | Primary |
Addresses
Primary practice location
3449 E Livingston Ave
Columbus, OH 43227-2220
Mailing address
5801 Thompson Rd
Gahanna, OH 43230-1349
Phone (614) 855-1170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080218000468 | OH | Practitioner - Clinical Psychologist | 0042393746 | Practice locations: Columbus, OH; Washington Court House, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3449 E Livingston Ave
Columbus, OH 43227-2220
Phone (614) 231-7255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3908 | OH | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190764800000",
"number": "1427019926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5801 THOMPSON RD",
"city": "GAHANNA",
"state": "OH",
"postal_code": "432301349",
"telephone_number": "614-855-1170",
"fax_number": "614-855-1170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3449 E LIVINGSTON AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432272220",
"telephone_number": "614-231-7255",
"fax_number": "614-855-1170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JANET",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-01",
"last_updated": "2007-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "3908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.