Stacy N Clark, PSYD is a
Student In An Organized Health Care Education/training Program based in Winfield, Illinois. Stacy N Clark is licensed to practice in * (Not Available) (license number ) and her current practice location is
28w671 Garys Mill Rd, Winfield, Illinois. She can be reached at her office (for appointments etc.) via phone at
(630) 293-9860.
NPI number for Stacy N Clark is 1821669409 and her current mailing address is 28w671 Garys Mill Rd, Winfield, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1821669409.
Healthcare Provider's Profile
| Full Name | Stacy N Clark |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 28w671 Garys Mill Rd, Winfield, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1821669409
- Provider Enumeration Date: 07/06/2021
- Last Update Date: 02/10/2022
Medical Identifiers
Medical identifiers for Stacy N Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821669409 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Stacy N 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 |
|---|
Stacy N Clark, PSYD
28w671 Garys Mill Rd,
Winfield, IL 60190-1564
Ph: (630) 293-9860 | Stacy N Clark, PSYD
28w671 Garys Mill Rd,
Winfield, IL 60190-1564
Ph: (630) 293-9860 |
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