MEDICARE: JENNIFER CLARK, PSY.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	1039	OK

General Provider Information

NPI Number	:	1972817781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNIFER CLARK, PSY.D., P.C.

Provider Business Mailing Address
First Line	:	1225 W MAIN ST STE 102
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-6851
Country	:	US
Telephone Number	:	405-305-6648
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 W MAIN ST
Second Line	:	STE 102
City	:	NORMAN
State	:	OK
Zip	:	73069-6824
Country	:	US
Telephone Number	:	405-292-1000
Fax Number	:	405-801-2506

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER CLARK
Credential	:	PSY.D.
Telephone Number	:	405-305-6648

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	02/11/2026

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