Brook Elizabeth Clark, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5032 Issued in MT

Practice address

400 15TH Ave S Ste 205
Great Falls, MT 59405-4375

Phone

(406) 731-8888

Fax

(406) 731-8318

NPI assigned

Jun 6, 2021

Last updated

Apr 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benefis Hospitals Inc

  dba Benefis Medical Group

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Benefis Hospitals Inc

  dba Benefis Medical Group

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • Air Ambulance
  • Great Falls, MT
  • NPI 1114934023

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1881650737
  Care Compare affiliation

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

{
    "created_epoch": "1622937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1831766146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6010",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594066010",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 15TH AVE S STE 205",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054375",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594053806",
            "country_code": "US",
            "telephone_number": "406-529-6432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BROOK",
        "middle_name": "ELIZABETH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-06",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MT",
            "license": "5032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bclark39109@benefishs.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "400 15th Ave S Ste 205",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594054375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Rae Cirilli
• City of Great Falls
• Roberta Sue Cladouhos-Powell, LCPC
• Alyssa Clark
• Belinda Clark, LMT, BCTMB
• Richard Lee Clark, CPO
• Clark's Orthopedic & Medical, Inc.
• Cyndy Clarke, LCPC
• Mary Ann Clausen, P.T.
• Lori G Clifton, CCC/SLP

• Psychologist in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Psychologist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.