Individual provider Active NPI

Robert Charles Clipper, PH.D.

  • Marriage & Family Therapist
  • O Fallon, IL
National Provider Identifier
1639134075
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1669 Windham Way
Suite B
O Fallon, IL 62269-3072
Phone
(618) 622-2579
Fax
(618) 624-8506
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IL Primary

Addresses

Primary practice location

1669 Windham Way
Suite B
O Fallon, IL 62269-3072

Mailing address

1669 Windham Way
Suite B
O Fallon, IL 62269-3072
Phone (618) 622-2579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 28, 2025 through Apr 28, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
166-000248ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates of Southern Illinois Past Accepting new patients
Clipper and Miller, PC Marriage & Family Therapist PastSince Nov 6, 2010 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639134075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 WINDHAM WAY",
            "address_2": "SUITE B",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693072",
            "telephone_number": "618-622-2579",
            "fax_number": "618-624-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 WINDHAM WAY",
            "address_2": "SUITE B",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693072",
            "telephone_number": "618-622-2579",
            "fax_number": "618-624-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIPPER",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.