Active NPI
Hannah Clark, PHD
- Clinical Psychologist
- Champaign, IL
National Provider Identifier
1851709026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071010348
- Practice address
- 515 N Hickory St Apt 202
Champaign, IL 61820-3889 - Phone
- (779) 236-6844
- NPI assigned
- Jul 31, 2014
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071010348 | IL | Primary |
Addresses
Primary practice location
515 N Hickory St Apt 202
Champaign, IL 61820-3889
Mailing address
515 N Hickory St Apt 202
Champaign, IL 61820-3889
Phone (779) 236-6844
Other practice location 1
500 E Washington St
Suite 100
Ann Arbor, MI 48104-2057
Phone (734) 764-3471
Other practice location 2
333 N Michigan Ave
Chicago, IL 60601-3901
Phone (779) 236-6844
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071010348 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarity Behavioral Health, LLC | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Somerville, MA
- NPI 1457135709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1851709026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 N HICKORY ST APT 202",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203889",
"telephone_number": "779-236-6844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 N HICKORY ST APT 202",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203889",
"telephone_number": "779-236-6844"
}
],
"practiceLocations": [
{
"address_1": "500 E Washington St",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "Ann Arbor",
"state": "MI",
"postal_code": "481042057",
"country_code": "US",
"telephone_number": "734-764-3471",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "333 N Michigan Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606013901",
"country_code": "US",
"telephone_number": "779-236-6844",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARK",
"first_name": "HANNAH",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-31",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071010348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.