NPIMap

Organization Active NPI

Karen Noelle Clark, PHD, PLLC

  • Clinical Psychologist
  • Southfield, MI
National Provider Identifier
1922565670
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KAREN NOELLE CLARK, PHD, PLLC
Practice address
26677 W 12 Mile Rd
Southfield, MI 48034-1514
Phone
(248) 909-2203
NPI assigned
Feb 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Dr. Karen Noelle Clark, PHD
Title
Independent Psychologist
Phone
(248) 909-2203

Specialties & licenses 1

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

Addresses

Primary practice location

26677 W 12 Mile Rd
Southfield, MI 48034-1514

Mailing address

PO Box 2206
Southfield, MI 48037-2206
Phone (248) 909-2203

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1922565670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2206",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480372206",
            "telephone_number": "248-909-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26677 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341514",
            "telephone_number": "248-909-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN NOELLE CLARK, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "NOELLE",
        "authorized_official_title_or_position": "INDEPENDENT PSYCHOLOGIST",
        "authorized_official_telephone_number": "248-909-2203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.