Mary Katherine Clark, MS,LPE-I is a
Psychologist - School based in Greenwood, Arkansas. Mary Katherine Clark is licensed to practice in Arkansas (license number 83-07E-I) and her current practice location is
320 N Main St, Greenwood, Arkansas. She can be reached at her office (for appointments etc.) via phone at
(479) 996-1414.
NPI number for Mary Katherine Clark is 1750546693 and her current mailing address is P. O. Box 3023, Greenwood, Arkansas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1750546693.
Healthcare Provider's Profile
| Full Name | Mary Katherine Clark |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist - School |
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| Location | 320 N Main St, Greenwood, Arkansas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1750546693
- Provider Enumeration Date: 07/21/2008
- Last Update Date: 07/21/2008
Medical Identifiers
Medical identifiers for Mary Katherine Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750546693 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 83-07E-I (Arkansas) | Secondary |
| 103TF0000X | Psychologist - Family | 83-07E-I (Arkansas) | Secondary |
| 103TP2701X | Psychologist - Group Psychotherapy | 83-07E-I (Arkansas) | Secondary |
| 103TS0200X | Psychologist - School | 83-07E-I (Arkansas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Katherine Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mary Katherine Clark, MS,LPE-I
P. O. Box 3023,
Greenwood, AR 72936-3020
Ph: (479) 996-1414 | Mary Katherine Clark, MS,LPE-I
320 N Main St,
Greenwood, AR 72936-7031
Ph: (479) 996-1414 |
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