CARLY CLARK PSYD
NPI 1972321214
Psychologist in Portland, ME

Active since September 26, 2024PECOS EnrolledAccepts Medicare Assignment
188 STATE ST STE 407, PORTLAND, ME 04101(207) 977-4321 Get Directions Write a Review

NPPES record last updated: November 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 13, 2025, Sep 26, 2024 (2 updates tracked since 2024).

About Carly Clark Psyd NPPES

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

CARLY CLARK PSYD (NPI 1972321214) is an individual psychologist in Portland, Maine, licensed in Maine (PS2605) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1972321214
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameCARLY CLARKCredential: PSYD
Location Address188 STATE ST STE 407Portland, ME 04101-5157
Mailing Address188 State St Ste 407Portland, ME 04101-5157 · (207) 977-4321
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateSeptember 26, 2024
Last NPPES UpdateNovember 13, 20252 updates tracked since enumeration
NPPES CertifiedNovember 13, 2025
NPI 1972321214 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in ME · PS2605
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.
188 STATE ST STE 407, Portland, ME 04101

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

Carly Clark Psyd 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 ID1850876392
PECOS Enrollment IDI20260401003075
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

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

Clinic/Center (Adult Mental Health)
188 STATE ST STE 407
PORTLAND, ME 04101

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 Carly Clark's NPI number?

The NPI number for Carly Clark is 1972321214. It was assigned to this individual provider in the NPPES registry on September 26, 2024.

Where is Carly Clark located?

Carly Clark practices at 188 State St Ste 407, Portland, ME 04101. The listed phone number is (207) 977-4321.

What is Carly Clark's specialty?

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

Is Carly Clark enrolled in Medicare?

Yes. Carly 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 Carly Clark was last updated on November 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.