Active NPI
Mary Holland Hoback Clark, MD
- Psychiatry Physician
- Institute, WV
National Provider Identifier
1760460802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 10892
- Practice address
- Barron Dr
Institute, WV 25112-1004 - Phone
- (304) 766-4855
- Fax
- (304) 766-4954
- NPI assigned
- Jan 9, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 10892 | WV | Primary |
Addresses
Primary practice location
Barron Dr
Institute, WV 25112-1004
Mailing address
PO Box 1004
Barron Dr
Institute, WV 25112-1004
Phone (304) 766-4855
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0116792000 | Medicaid | WV | |
| 10892 | Other | WV | WV BD OF MEDECINE |
Other names 1
- Mrs. Holly Hoback Clark
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10892 | WV | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St of WV Div of Rehabilitation Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Clinic/Center
- Institute, WV
- NPI 1619951977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1760460802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1004",
"address_2": "BARRON DR",
"city": "INSTITUTE",
"state": "WV",
"postal_code": "251121004",
"telephone_number": "304-766-4855",
"fax_number": "304-766-4954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BARRON DR",
"city": "INSTITUTE",
"state": "WV",
"postal_code": "251121004",
"telephone_number": "304-766-4855",
"fax_number": "304-766-4954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "MARY",
"middle_name": "HOLLAND HOBACK",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WV",
"license": "10892",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0116792000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WV BD OF MEDECINE",
"identifier": "10892",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "HOLLY",
"last_name": "CLARK",
"middle_name": "HOBACK",
"prefix": "MRS.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Institute, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.