Dr. William H Clark, Ph.D.
Psychologist in Ridgewood, NJ. Individual provider (NPI-1).
NPI number1366464364
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1366464364
- Entity type
- Individual (NPI-1)
- Name
- Dr. William H Clark
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 25, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL PSYCHOLOGIST
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 35SI00115900 | NJ | Yes |
Practice location
530 N Maple AveRidgewood, NJ 07450-1610
Phone 201-689-8293 · Fax 201-689-8293
Mailing address
311 Kenilworth RdRidgewood, NJ 07450-5201
Phone 201-689-8293 · Fax 201-689-8293
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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