Active NPI
Stephen Clarke, PH.D.
- Counseling Psychologist
- Baltimore, MD
National Provider Identifier
1740739994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LC4084
- Practice address
- 3000 Chestnut Ave
Suite 204
Baltimore, MD 21211-2727 - Phone
- (410) 303-8201
- NPI assigned
- Sep 29, 2016
- Last updated
- Sep 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LC4084 | MD | Primary |
Addresses
Primary practice location
3000 Chestnut Ave
Suite 204
Baltimore, MD 21211-2727
Mailing address
3000 Chestnut Ave
Suite 204
Baltimore, MD 21211-2727
Phone (410) 303-8201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241209002022 | MD | Practitioner - Mental Health Counselor | 8820524291 | Practice locations: Owings Mills, MD |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC4084 | MD | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475107200000",
"number": "1740739994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 CHESTNUT AVE",
"address_2": "SUITE 204",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212112727",
"telephone_number": "410-303-8201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 CHESTNUT AVE",
"address_2": "SUITE 204",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212112727",
"telephone_number": "410-303-8201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARKE",
"first_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-29",
"last_updated": "2016-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MD",
"license": "LC4084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.