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DOMINIQUE CLARK
NPI 1841934544
Psychologist - Addiction (Substance Use Disorder) in Florissant, MO

Active since April 27, 2022
1150 GRAHAM RD, FLORISSANT, MO 63031(314) 250-8277 Get Directions Write a Review

NPPES record last updated: April 27, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dominique Clark NPPES

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

DOMINIQUE CLARK (NPI 1841934544) is an individual addiction (substance use disorder) provider in Florissant, Missouri and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1841934544
Entity TypeIndividualMale
Primary Taxonomy103TA0400X
Provider Legal NameDOMINIQUE CLARK
Location Address1150 GRAHAM RDFlorissant, MO 63031-8077
Mailing Address5570 Vernon AveSaint Louis, MO 63112-2756 · (314) 546-9028
Phone(314) 250-8277
Sole ProprietorNo
Enumeration DateApril 27, 2022
NPPES CertifiedApril 27, 2022
✔ NPI 1841934544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code103TA0400X
Definition
A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.
1150 GRAHAM RD, Florissant, MO 63031
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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.

MARTHA TOLBERT
Social Worker
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 206-3900
MCKENZIE REIN GAMACHE
Social Worker (Clinical)
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 206-3900
DEBORAH ANN WILSON
Behavior Technician
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 206-3900
DEANA HUFF
Case Manager/Care Coordinator
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 435-0021
LARRY EDGER II MSW
Case Manager/Care Coordinator
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 625-7583
LATASHA ANN NEWTON MSP
Case Manager/Care Coordinator
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 206-3900
CINDY GRAYDON
Social Worker
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 206-3400
MRS. MILDRED ELIZABETH FORTUNE-GILPIN MSW, LCSW
Social Worker (Clinical)
1150 GRAHAM RD
FLORISSANT, MO 63031
St. Louis County (314) 206-3900

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 Dominique Clark's NPI number?

The NPI number for Dominique Clark is 1841934544. It was assigned to this individual provider in the NPPES registry on April 27, 2022.

Where is Dominique Clark located?

Dominique Clark practices at 1150 Graham Rd, Florissant, MO 63031. The listed phone number is (314) 250-8277.

What is Dominique Clark's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

When was this NPI record last updated?

The NPPES record for Dominique Clark was last updated on April 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.