DR. CYNTHIA ADRIAN CLARK PH.D.
NPI 1740304807
Psychologist in Carbondale, IL

Active since March 16, 2007PECOS EnrolledAccepts Medicare Assignment
231 W MAIN ST, SUITE 2-W, CARBONDALE, IL 62901(618) 549-1793(618) 549-1793 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Cynthia Adrian Clark Ph.d. NPPES

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

DR. CYNTHIA ADRIAN CLARK PH.D. (NPI 1740304807) is an individual psychologist in Carbondale, Illinois and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1990).

NPPES Registry Identity

NPI1740304807
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. CYNTHIA ADRIAN CLARKCredential: PH.D.
Location Address231 W MAIN ST, SUITE 2-WCarbondale, IL 62901-2948
Mailing Address231 W Main St Ste 2-wCarbondale, IL 62901-2948 · (618) 549-1793 · Fax (618) 549-1793
Fax(618) 549-1793
Sole ProprietorYes
Medical School CMSOtherGraduated 1990
Enumeration DateMarch 16, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1740304807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
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.
231 W MAIN ST, Carbondale, IL 62901

Other Identifiers 4

Medicare ID-Type Unspecified359130IL
Other189452IL · Health Link
Other039-72018IL · Blue Cross & Blue Shield
Other040796IL · Health Alliance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Cynthia Adrian Clark Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840355962
PECOS Enrollment IDI20090224000371
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.

Other Providers at the Same Location NPPES 4

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

Psychologist (Clinical)
231 W MAIN ST, SUITE 1 WEST
CARBONDALE, IL 62901
Psychologist
231 W MAIN ST, SUITE 1W
CARBONDALE, IL 62901
Counselor (Professional)
231 W MAIN ST, SUITE 2-W
CARBONDALE, IL 62901
Counselor (Mental Health)
231 W MAIN ST
CARBONDALE, IL 62901

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 Cynthia Clark's NPI number?

The NPI number for Cynthia Clark is 1740304807. It was assigned to this individual provider in the NPPES registry on March 16, 2007.

Where is Cynthia Clark located?

Cynthia Clark practices at 231 W Main St Suite 2-W, Carbondale, IL 62901. The listed phone number is (618) 549-1793.

What is Cynthia Clark's specialty?

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

Is Cynthia Clark enrolled in Medicare?

Yes. Cynthia Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Cynthia Clark was last updated on July 8, 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.