DR. ROBERT ROY CLARK (NPI# 1629008453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629008453 |
| Entity Type | Individual |
| Full Name | DR. ROBERT ROY CLARK |
| Credential | PH.D. |
| Practice Address |
176 Route 81 Killingworth CT 06419-1422 |
| Mailing Address |
232 Route 80 Killingworth CT 06419-1406 |
| Practice Telephone | 8606632668 |
| Practice Fax Number | 8606632488 |
| Mailing Telephone | 8606632138 |
| Mailing Fax Number | 8606632488 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 4648 | NY | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 2170 | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457989048 | Robert William Clark | Registered Nurse | 1511 Se 16th Ave, Ocala, FL 34471-4627 | 2020-03-30 |
| 1578012225 | Robert Clark | Technician, Other | 5075 Belmere Dr, Manitou Beach, MI 49253-9626 | 2016-09-22 |
| 1447535620 | Robert Leal Clark | Ophthalmology | 901 Forest Ave., Johnson City, TN 37601 | 2011-10-19 |
| 1619287216 | Robert Earl Clark | Occupational Therapist | 6623 N Main St, Davenport, IA 52806 | 2010-10-15 |
| 1376778746 | Robert T Clark Sr. | Chiropractor | 2411 Us Highway 27 S, Sebring, FL 33870-4943 | 2009-05-28 |
| 1538358924 | Robert Coleman Clark | Massage Therapist | 1501b Grape St, Tallahassee, FL 32303-5637 | 2007-10-22 |
| 1376765925 | Robert Clark | Nurse Practitioner | Employee and Occupational Health, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2007-05-03 |
| 1396963666 | Robert Clark | Licensed Practical Nurse | 26347 Lake Lindsey Rd, Brooksville, FL 34601-4304 | 2007-04-23 |
| 1770708349 | Robert Douglas Clark | Physical Therapist | 3580 Discovery Dr, Grove City, OH 43123-9329 | 2007-04-17 |
| 1053432633 | Robert Joseph Clark | Dentist | 5323 Brainerd Rd Ste 105, Chattanooga, TN 37411-5305 | 2007-04-02 |
| Street Address |
176 ROUTE 81 |
| City | KILLINGWORTH |
| State | CT |
| Zip Code | 06419-1422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225244999 | Rachael K. Leombruno | Marriage & Family Therapist | 176 Route 81, Killingworth, CT 06419-1422 | 2007-05-16 |
| 1619908258 | Lynn Monahan | Psychologist | 176 Route 81, Killingworth, CT 06419-1422 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689126336 | Geoffrey Etherington | Preventive Medicine | 302 Rte 81, Killingworth, CT 06419 | 2016-10-28 |
| 1497997225 | Beth Zukowski | Skilled Nursing Facility | 150 Schnoor Road, Killingworth, CT 06419 | 2009-03-25 |
| 1154491041 | Ronald E. Wygonik | Dentist | 184 Route 81, Killingworth, CT 06419 | 2006-11-08 |
| 1922119114 | Cynthia Lee Sarris | Social Worker | 46 Granite Hill Rd, Killingworth, CT 06419 | 2006-08-31 |
| 1770190290 | Michelle Ann Serbent | Occupational Therapist | 4 County Rd, Killingworth, CT 06419-1004 | 2020-09-29 |
| 1962752030 | Kelsey Ann Kearns Buttendorf | Counselor | 147 Pond Meadow Rd, Killingworth, CT 06419-1122 | 2012-09-14 |
| 1417467879 | Onecalltherapy,llc | Clinic/Center | 193 N Parker Hill Rd, Killingworth, CT 06419-1124 | 2017-10-11 |
| 1154458545 | Peter Bohuslav Zelinka | Radiology | 221 N Parker Hill Rd, Killingworth, CT 06419-1124 | 2007-02-27 |
| 1255468443 | Jane Elizabeth Robinson | Psychologist | 50 Bethke Rd, Killingworth, CT 06419-1133 | 2007-02-27 |
| 1346516341 | Evr Mental Health Services, LLC | Marriage & Family Therapist | 9 Lovers Ln, Killingworth, CT 06419-1155 | 2012-03-24 |
| Find all providers in zip 06419 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619908258 | Lynn Monahan | Psychologist | 176 Route 81, Killingworth, CT 06419-1422 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363962 | Tyrek J Pratt LLC | Psychologist | 74 New London Tpke Ste 1, Glastonbury, CT 06033-4204 | 2020-10-16 |
| 1003413493 | Dominica B Hernandez | Psychologist | 4 Doubleday Rd, Columbia, CT 06237-1405 | 2020-10-08 |
| 1861009417 | Margaret Mary Maher | Psychologist | 225 Main St # Ll, Westport, CT 06880-3216 | 2020-09-28 |
| 1831705573 | Meredith Poster | Psychologist | 6 Rustic Lane, Westport, CT 06880 | 2020-09-18 |
| 1407461619 | Kathy Yuen | Psychologist | 34 Clearview Ave, West Hartford, CT 06119-2201 | 2020-09-14 |
| 1730706912 | Albert Petitpas | Psychologist | 130 Butternut Ln, Kensington, CT 06037-1200 | 2020-07-03 |
| 1285267880 | Margaret Taylor Davis | Psychologist | 2 Church St S Ste 511, New Haven, CT 06519-1760 | 2020-02-21 |
| 1871139196 | Joseph Demers | Psychologist | 330 Post Rd, Darien, CT 06820-3600 | 2019-11-21 |
| 1063053114 | Safe Haven Psychological Services LLC | Psychologist | 491 Main St Ste D, Branford, CT 06405-3505 | 2019-09-30 |
| 1578113403 | Janet Mentore Lee | Psychologist | 124 Woodridge Dr, New Canaan, CT 06840-3511 | 2019-09-12 |
| Find all providers with the same taxonomy | ||||
| City | KILLINGWORTH |
| Zip Code | 06419 |
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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.