DR. MICHAEL E CLARK PH.D. - NPI 1487626172

Q: What is Michael Clark's NPI number?

The NPI number for Michael Clark is 1487626172. It was assigned to this individual provider in the NPPES registry on February 6, 2006.

Q: What is Michael Clark's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Health Service, with taxonomy code 103TH0100X.

Q: When was this NPI record last updated?

The NPPES record for Michael Clark was last updated on July 12, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

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About Dr. Michael E Clark Ph.d. NPPES

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

DR. MICHAEL E CLARK PH.D. (NPI 1487626172) is an individual health service provider in Tampa, Florida, licensed in Florida (PY3564) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1487626172

Entity TypeIndividualMale

Primary Taxonomy103TH0100X

Provider Legal NameDR. MICHAEL E CLARKCredential: PH.D.

Location Address13000 BRUCE B DOWNS BLVD, PAIN PROGRAM (2CW)Tampa, FL 33612-4745

Mailing Address13000 Bruce B Downs Blvd, Pain Program (2cw)Tampa, FL 33612-4745 · (813) 972-2000 · Fax (813) 978-5867

Phone(813) 972-2000

Fax(813) 978-5867

Sole ProprietorYes

Enumeration DateFebruary 6, 2006

Last NPPES UpdateJuly 12, 2007

✔ NPI 1487626172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Health ServiceBehavioral Health & Social Service Providers

Taxonomy Code103TH0100X

License✔ Licensed in FL · PY3564

Definition

A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).

13000 BRUCE B DOWNS BLVD, Tampa, FL 33612

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Other Providers at the Same Location NPPES 20

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

DEREK ROBBEN MD

Psychiatry & Neurology (Psychiatry)

13000 BRUCE B DOWNS BLVD, 116A
TAMPA, FL 33612

Hillsborough County (813) 631-2575

DR. LUIS LEON ALVARADO MD

Internal Medicine

13000 BRUCE B DOWNS BLVD, VA 111
TAMPA, FL 33612

Hillsborough County (813) 972-2000

MS. JAMIE LEE GREEN M.S.ED., MSW

Social Worker (Clinical)