DR. CHRISTY A CLARK PH.D.
NPI 1760411102
Psychologist - Clinical in Northborough, MA

Q: What is Christy Clark's NPI number?

The NPI number for Christy Clark is 1760411102. It was assigned to this individual provider in the NPPES registry on June 30, 2006.

Q: What is Christy Clark's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Christy Clark enrolled in Medicare?

No. Christy Clark has opted out of Medicare through January 4, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Christy Clark was last updated on June 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since June 30, 2006Opted out of Medicare · through Jan 4, 2028

300 W MAIN ST, BLDG A, NORTHBOROUGH, MA 01532(508) 856-2551(508) 856-5320 Get Directions Write a Review

NPPES record last updated: June 20, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Christy A Clark Ph.d. NPPES

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

DR. CHRISTY A CLARK PH.D. (NPI 1760411102) is an individual clinical provider in Northborough, Massachusetts, licensed in Massachusetts (7966) and active in the NPI registry since June 2006. She has opted out of Medicare through January 4, 2028.

NPPES Registry Identity

NPI1760411102

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. CHRISTY A CLARKCredential: PH.D.

Location Address300 W MAIN ST, BLDG ANorthborough, MA 01532-2132

Mailing Address300 W Main St, Bldg ANorthborough, MA 01532-2132 · (508) 334-8815 · Fax (508) 334-5374

Phone(508) 856-2551

Fax(508) 856-5320

Sole ProprietorNo

Enumeration DateJune 30, 2006

Last NPPES UpdateJune 20, 2016

✔ NPI 1760411102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MA · 7966

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

300 W MAIN ST, Northborough, MA 01532

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Christy A Clark Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 4, 2022 through January 4, 2028.

Opt-Out Effective DateJanuary 4, 2022

Opt-Out In Effect ThroughJanuary 4, 2028Opt-out affidavits renew automatically every two years unless cancelled

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.

MERCY TANDOH LMHC

Counselor (Mental Health)