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General NPI Number Information
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NPI Number | 1053180117
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Entity Type | Organization
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Legal Business Name | DANIEL CLARK PSYCHOLOGIST PLLC
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Dates
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Enumeration Date | 12/29/2023
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 1133 BROADWAY STE 1127
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City | NEW YORK
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State | NY
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Zip | 10010-7973
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Country | US
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Telephone | 562-314-1999
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Fax | 855-595-2754
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Provider Business Mailing Address
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Address Line | 1133 BROADWAY STE 1127
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City | NEW YORK
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State | NY
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Zip | 10010-7973
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Country | US
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Telephone | 562-314-1999
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Fax | 855-595-2754
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Authorized Official
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Title or Position | OWNER/CLINICAL PSYCHOLOGIST
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Name | DR. DANIEL CLARK
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Credential | PHD
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Telephone | 617-249-4466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number State |
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