Joshua Clark, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2597 Issued in OR

Practice address

1509 SW Sunset Blvd Ste 2C
Portland, OR 97239-2689

Phone

(503) 395-8850

NPI assigned

Jun 21, 2016

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 OR

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Susannah Castle PSYD LLC

  • Psychologist
  • Portland, OR
  • NPI 1699641183
  NPD

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1457701336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8848 SW 51ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193355",
            "telephone_number": "503-395-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 SW SUNSET BLVD STE 2C",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392689",
            "telephone_number": "503-395-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JOSHUA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500730746",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Justina Clark, FNP-BC
• Jennifer R Clark, PSYD
• Jill Clark, LCSW
• Jolynn Clark, ABO, NCLE
• Jordan Dyann Clark
• Justin Clark, LMT
• Kalin Burkhardt Clark, PSY.D
• Karmen Clark
• Katrina Ann Clark, CSWA
• Kendall Olivia Clark

• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.