STACY CLARK (NPI# 1053625764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053625764 |
| Entity Type | Individual |
| Full Name | STACY CLARK |
| Credential | PH.D. |
| Practice Address |
25 E Washington St 1719 Chicago IL 60602-1708 |
| Mailing Address |
25 E Washington St 1791 Chicago IL 60602-1708 |
| Practice Telephone | 7732630003 |
| Mailing Telephone | 7732630003 |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2014-10-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071.007953 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861628380 | Stacy Clark | Counselor | 2156 Seastone Trce, Chesapeake, VA 23321-3777 | 2009-06-10 |
| 1912016494 | Stacy Ann Clark | Optometrist | 1601 E Iron Ave, Salina, KS 67401-3237 | 2006-08-29 |
| 1801841606 | Stacy Suzanne Clark | Chiropractor | 6 Ebco Circle, Waynesboro, VA 22980 | 2006-05-23 |
| 1669012647 | Stacy Ann Clark | Counselor | 460 Briarwood Dr Ste 510, Jackson, MS 39206-3057 | 2020-01-08 |
| 1881047124 | Stacy Clark | Marriage & Family Therapist | 24451 Health Center Dr, Laguna Hills, CA 92653-3689 | 2016-07-21 |
| 1295199941 | Stacy Ann Clark | Nurse Practitioner | 3245 Mount Moriah Ave, Suite 10, Owensboro, KY 42303-7834 | 2016-04-08 |
| 1689950479 | Stacy Clark | Pharmacist | 52482 State Road 933, South Bend, IN 46637-3852 | 2011-10-25 |
| 1114259637 | Stacy L Clark | Massage Therapist | 6290 W Sample Rd, Coral Springs, FL 33067-3101 | 2010-02-09 |
| 1134375314 | Stacy Clark | Physical Therapist | 11623 Arbor St, Omaha, NE 68144-2981 | 2008-08-07 |
| 1619145497 | Stacy Clark | Counselor | 367 Pine St, Springfield, MA 01105-1930 | 2008-02-14 |
| Street Address |
25 E WASHINGTON ST 1719 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60602-1708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245227867 | Lawrence H Zager | Dentist | 25 E Washington St, # 825, Chicago, IL 60602-1708 | 2005-09-29 |
| 1417442021 | William David Ewing IIi | Counselor | 25 E Washington St, Chicago, IL 60602-1708 | 2018-06-26 |
| 1609379635 | Richla Davis | Counselor | 25 E Washington St, Chicago, IL 60602-1708 | 2018-03-15 |
| 1548785769 | Ida D Andarge | Social Worker | 25 E Washington St, Chicago, IL 60602-1708 | 2017-08-09 |
| 1326577362 | Asa Derrick Carson | Dentist | 25 E Washington St, Chicago, IL 60602-1708 | 2017-06-05 |
| 1023544731 | Speak Chicago Psychotherapy LLC | Social Worker | 25 E Washington St, Suite 1908, Chicago, IL 60602-1708 | 2017-05-02 |
| 1427583830 | Hannah Smith Therapy and Wellness | Marriage & Family Therapist | 25 E Washington St, Suite 1225, Chicago, IL 60602-1708 | 2017-04-23 |
| 1801328588 | Katelyn Schmitt | Counselor | 25 E Washington St, Suite 2036, Chicago, IL 60602-1708 | 2017-03-31 |
| 1255871083 | Equilibrium Counseling Center | Clinic/Center | 25 E Washington St, Suite 1724, Chicago, IL 60602-1708 | 2017-02-27 |
| 1336688902 | Julia Meo | Counselor | 25 E Washington St, #2036, Chicago, IL 60602-1708 | 2017-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710539705 | Biyang Wang | Social Worker | 9 W Washington St, Chicago, IL 60602 | 2019-07-10 |
| 1538724349 | Megan Asta Sarasek | Social Worker | 134 N Lasalle Street, Suite 400, Chicago, IL 60602 | 2019-05-07 |
| 1659850691 | Sara Chen | Dentist | 105 West Madison, 3rd Floor, Chicago, IL 60602 | 2018-08-10 |
| 1942795059 | Pratiti Rajeshkumar Gandhi | Dentist | 33 N Dearborn St Ste 2400, Chicago, IL 60602 | 2018-06-30 |
| 1154833994 | Ywca Metropolitan Chicago | Counselor | 1 North Lasalle Street, Suite 1150, Chicago, IL 60602 | 2017-11-02 |
| 1013434620 | Michelle Malters | Counselor | 30 N Michigan Ave Ste 1909, Chicago, IL 60602 | 2017-08-24 |
| 1740729474 | Jd Manikowski, D.d.s., LLC | Health Maintenance Organization | 30 N. Michigan Ave #1520, Chicago, IL 60602 | 2017-02-14 |
| 1568909943 | Pratiksha Agrawal | Dentist | 105 W Madison St Fl 3, Chicago, IL 60602 | 2017-01-24 |
| 1790221521 | Anastasia Scangas | Social Worker | 30 N Michigan Ave Ste 826, Chicago, IL 60602 | 2017-01-18 |
| 1194269837 | Jenna Peterson | Psychologist | 111 N Wabash Ave Ste 822, Chicago, IL 60602 | 2016-12-15 |
| Find all providers in zip 60602 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1730792151 | Jenny Marie Wamsat | Psychologist | 1921 W Diversey Pkwy Apt 402, Chicago, IL 60614-9412 | 2020-08-25 |
| 1497365910 | Sara Sirota | Psychologist | 5443 N Broadway St # 2s, Chicago, IL 60640-1703 | 2020-08-10 |
| 1053920512 | Alyse Renae Bedell | Psychologist | 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 | 2020-07-30 |
| 1699392688 | Hongying Chen | Psychologist | 720 W Sheridan Rd Apt 3s, Chicago, IL 60613-3252 | 2020-06-25 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.