Elaine Clark, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0047425017 Issued in UT

Practice address

501 Chipita Way
Univ of Utah Neuropsychiatric Institute
Salt Lake City, UT 84108

Phone

(801) 583-2500

NPI assigned

Mar 5, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1770612863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 CHIPITA WAY",
            "address_2": "UNIV OF UTAH NEUROPSYCHIATRIC INSTITUTE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84108",
            "telephone_number": "801-583-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CHIPITA WAY",
            "address_2": "UNIV OF UTAH NEUROPSYCHIATRIC INSTITUTE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84108",
            "telephone_number": "801-583-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "UT",
            "license": "0047425017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eclark99114@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claire H Clark, PHD
• Damien Clark, MD
• Danielle Morgan Clark, PA-C
• Debra Joyce Healy Clark, CSW
• Dresden Lyn Clark, LSUDC
• Ellen P. Clark, MD
• Erik Martin Clark
• Hannah Clark
• Herald Ruth Clark, DDS,PC
• Holly Clark, M.D.

• Clinical Neuropsychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Neuropsychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.