Dulin W Clark, PH.D.

Individual provider Active NPI Counseling Psychologist · Hollidaysburg, PA

NPI 1447560636 · NPPES record last updated Dec 17, 2018

Key facts

NPI
1447560636
Entity type
Individual (NPI type 1)
Primary specialty
Counseling Psychologist 103TC1900X
License
PS009217L (PA)
Practice address
416 Allegheny St FL 1
Hollidaysburg, PA 16648-2026
Phone
(814) 505-3248
NPI assigned
Oct 21, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

416 Allegheny St
FL 1
Hollidaysburg, PA 16648-2026
Phone (814) 505-3248

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110928000039 PA Practitioner - Clinical Psychologist 8527239375 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS009217LPAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Counseling and Consulting LLC Counseling Current
since Aug 3, 2011
Accepting new patients

Locations

416 Allegheny St
Fl 1
Hollidaysburg, PA 16648
Phone (814) 505-3248

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PS009217L PA Yes

Addresses

Primary practice location

416 Allegheny St FL 1
Hollidaysburg, PA 16648-2026

Mailing address

416 Allegheny St
Hollidaysburg, PA 16648-2026
Phone (814) 505-3248

Other providers in Hollidaysburg, PA

All providers in Hollidaysburg, PA · Counseling Psychologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.