NPIMap

Organization Active NPI

Constance Avery-Clark, PH.D., LLC

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1750826285
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY3980 Issued in FL
Legal business name
CONSTANCE AVERY-CLARK, PH.D., LLC
Practice address
7100 W Camino Real
Suite 302, #7
Boca Raton, FL 33433-5510
Phone
(954) 849-7997
NPI assigned
Dec 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Authorized official

Name
Dr. Constance Avery-Clark, PH.D.
Title
Owner
Phone
(954) 849-7997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY3980 FL Primary

Addresses

Primary practice location

7100 W Camino Real
Suite 302, #7
Boca Raton, FL 33433-5510

Mailing address

7100 W Camino Real
Suite 302, #7
Boca Raton, FL 33433-5510

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1750826285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 W CAMINO REAL",
            "address_2": "SUITE 302, #7",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W CAMINO REAL",
            "address_2": "SUITE 302, #7",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335510",
            "telephone_number": "954-849-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTANCE AVERY-CLARK, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "AVERY-CLARK",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-849-7997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY3980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.