Clark Institute Psychology PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

CLARK INSTITUTE PSYCHOLOGY PLLC

Practice address

7150 Kalamazoo Ave SE
Suite C
Caledonia, MI 49316

Phone

(616) 219-0159

Fax

(616) 219-0124

NPI assigned

Jan 3, 2019

Last updated

Jan 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew ClarkNPI 1811001126

Title

Owner

Phone

(616) 204-5589

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

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.

• Matthew David Ayers Clark, PSY.D., FLP

  • Psychologist
  • Caledonia, MI
  • NPI 1811001126
  Medicare reassignment Authorized official
• Katie L Kilmartin, LLPC

  • Professional Counselor
  • Holland, MI
  • NPI 1225382120
  NPD (past)
• Melissa Muir, LLP

  • Counseling Psychologist
  • Grand Rapids, MI
  • NPI 1124474820
  NPD (past)
• Erika Ingrid Oliver, MA, LLP, CAADC

  • Counseling Psychologist
  • Grand Rapids, MI
  • NPI 1306033238
  NPD (past)
• Meagan Ross

  • Mental Health Counselor
  • Howard City, MI
  • NPI 1710572821
  NPD (past)

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547683200000",
    "number": "1508339524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 KALAMAZOO AVE SE",
            "address_2": "SUITE C",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "49316",
            "telephone_number": "616-219-0159",
            "fax_number": "616-219-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 KALAMAZOO AVE SE",
            "address_2": "SUITE C",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "49316",
            "telephone_number": "616-219-0159",
            "fax_number": "616-219-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK INSTITUTE PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-01-17",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-204-5589"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Anthony Chapp, D.C.
• Alexandra Cherny
• Maria A Chichester, D.C.
• Chiropractic and Beyond
• Fawn Cichoski, MSW
• James Clark, DPT
• Matthew David Ayers Clark, PSY.D., FLP
• Clear Visions Counseling
• Emily Cline
• Krystal M Cole, PHARMD

• Psychologist in Caledonia, MI
• Providers in Caledonia, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.