RACHEAL CLARK PH.D., BCBA
NPI 1124685805
Psychologist in Clarksville, MD

Active since May 28, 2019PECOS Enrolled
6100 DAYLONG LN STE 103, CLARKSVILLE, MD 21029(410) 531-8100 Get Directions Write a Review

NPPES record last updated: October 19, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 19, 2021, May 28, 2019 (2 updates tracked since 2019).

About Racheal Clark Ph.d., Bcba NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RACHEAL CLARK PH.D., BCBA (NPI 1124685805) is an individual psychologist in Clarksville, Maryland, licensed in Maryland (06447) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124685805
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameRACHEAL CLARKCredential: PH.D., BCBA
Location Address6100 DAYLONG LN STE 103Clarksville, MD 21029-1631
Mailing Address6100 Daylong Ln Ste 103Clarksville, MD 21029-1631 · (410) 531-8100
Sole ProprietorNo
Enumeration DateMay 28, 2019
Last NPPES UpdateOctober 19, 20212 updates tracked since enumeration
NPPES CertifiedOctober 19, 2021
✔ NPI 1124685805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MD · 06447
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
6100 DAYLONG LN STE 103, Clarksville, MD 21029

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Racheal Clark Ph.d., Bcba is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Racheal Clark reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Clinical
6100 DAYLONG LN STE 103
Clarksville, MD 21029
  • Reassigned Medicare billing, Maryland enrollment
  • 5 clinicians in this Medicare group
Clinical
1511 RITCHIE HWY STE 202
Arnold, MD 21012
  • Reassigned Medicare billing, Maryland enrollment
  • Medicare enrollment name: Arundel Mental Health Professionals Lc
  • 124 clinicians in this Medicare group
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, District of Columbia enrollment
  • 1,424 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Analyst
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029
Counselor (Mental Health)
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029
Counselor (Professional)
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029
Counselor (Mental Health)
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029
Social Worker (Clinical)
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029
Social Worker
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029
Psychologist (Clinical)
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029
Behavior Technician
6100 DAYLONG LN STE 103
CLARKSVILLE, MD 21029

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Racheal Clark's NPI number?

The NPI number for Racheal Clark is 1124685805. It was assigned to this individual provider in the NPPES registry on May 28, 2019.

Where is Racheal Clark located?

Racheal Clark practices at 6100 Daylong Ln Ste 103, Clarksville, MD 21029. The listed phone number is (410) 531-8100.

What is Racheal Clark's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Racheal Clark enrolled in Medicare?

Yes. Racheal Clark is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Racheal Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Racheal Clark reassigns Medicare benefits to 3 organizations: Brighter Hope Wellness Center (Clarksville, MD), Arundel Mental Health Professionals L.C. (Arnold, MD) and Grow Healthcare Group PA (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Racheal Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Racheal Clark was last updated on October 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.