NPIMap

Organization Active NPI

Clark Psychological Associates

  • Cognitive & Behavioral Psychologist
  • Montgomery, AL
National Provider Identifier
1437394103
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
1076 Issued in AL
Legal business name
CLARK PSYCHOLOGICAL ASSOCIATES
Practice address
3196 Parliament Circle
Montgomery, AL 36116-0000
Phone
(334) 300-7021
NPI assigned
Dec 10, 2008
Last updated
Dec 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Dr. Daniel C Clark, PH.D.NPI 1225093891
Title
Owner
Phone
(334) 300-7021

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 1076 AL Primary

Addresses

Primary practice location

3196 Parliament Circle
Montgomery, AL 36116-0000

Mailing address

9571 Winfield PL
Montgomery, AL 36117-5157
Phone (334) 300-7021

Other identifiers 1

IdentifierTypeStateIssuer
1225093891OtherNPI - PERSONAL ISSUED TO DR. CLARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090428000499 AL Part B Supplier - Clinic/Group Practice 5890843056 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

3196 Parliament Cir
Montgomery, AL 36116
Phone (334) 300-7021

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1437394103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9571 WINFIELD PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361175157",
            "telephone_number": "334-300-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 PARLIAMENT CIRCLE",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361160000",
            "telephone_number": "334-300-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK PSYCHOLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-300-7021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AL",
            "license": "1076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - PERSONAL ISSUED TO DR. CLARK",
            "identifier": "1225093891",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.