Megan Maureen Clarke, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

8.003717 Issued in CT

Practice address

3 Forest Park Dr Ste 101
Farmington, CT 06032-1468

Phone

(860) 470-4560

NPI assigned

Feb 8, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 1, 2024 through May 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Wellspring Psychological Services, LLC

  • Psychologist
  • Farmington, CT
  • NPI 1366939191
  NPD (past) Authorized official

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1578062295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 MIDLANDS DR",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071022",
            "telephone_number": "860-470-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 FOREST PARK DR STE 101",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321468",
            "telephone_number": "860-470-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "MEGAN",
        "middle_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "8.003717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Renea Civitillo, DDS
• Claim, LLC
• Cori Clark, DO
• Evan Clark, DO
• Robert B. Clark, MD
• Sandra Rae Clarke, LCSW
• Mathew Clavero
• Clean and Green Cleaning Service,LLC
• Karen Cleaveland, APRN
• Rebecca Cleaveland

• Psychologist in Farmington, CT
• Providers in Farmington, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.