MATTHEW DAVID AYERS CLARK (NPI# 1811001126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811001126 |
| Entity Type | Individual |
| Full Name | MATTHEW DAVID AYERS CLARK |
| Credential | PSY.D., FLP |
| Practice Address |
7150 Kalamazoo Ave Se Ste C Caledonia MI 49316-9126 |
| Practice Telephone | 6166905437 |
| Practice Fax Number | 6168256225 |
| Mailing Telephone | 6166905437 |
| Mailing Fax Number | 6168256225 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2019-01-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 6301013305 | MI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
6301013305 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE | D16189090 | 01 |
| MI | BLUE CROSS BLUE SHIELD | 0897749 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 600 Broadway Ave Nw, Suite 435/c5, Grand Rapids, MI 495047305 | 6166905437 | 6168256225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033578653 | Matthew Mitchell Clark | Student in an Organized Health Care Education/Training Program | 2644 Crystal Falls Rd, Lexington, KY 40509-4208 | 2016-02-11 |
| 1154787844 | Matthew Clark | Chiropractor | 5250 S Commerce Dr Ste 155, Murray, UT 84107-5379 | 2016-01-11 |
| 1215993308 | Matthew Alexander Clark | Internal Medicine | Ute Mountain Ute Health Center, Complex B Rustling Willow Street, Towaoc, CO 81334-0049 | 2006-04-26 |
| 1407341134 | Matthew Howard Clark | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905 | 2018-06-25 |
| 1639674591 | Matthew Anthony Clark | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2018-03-24 |
| 1588104913 | Matthew Louis Clark | Pharmacist | 4747 Sawmill Rd, Columbus, OH 43220-2490 | 2017-03-04 |
| 1679949184 | Matthew Clark | Optometrist | 2792 E 146th St, Carmel, IN 46033-7718 | 2015-08-19 |
| 1902288806 | Matthew Lewis Clark | Dermatology | 8245 Holly Rd Ste 101, Grand Blanc, MI 48439-2443 | 2015-06-26 |
| 1417353996 | Matthew Clark | Counselor | 360 Bloomfield Ave, Ste 301, Windsor, CT 06095-2700 | 2014-11-12 |
| 1467872044 | Matthew Thomas Clark | Pediatrics | 2200 Childrens Way, Suite 2404, Nashville, TN 37232-0005 | 2014-04-22 |
| Street Address |
7150 KALAMAZOO AVE SE STE C |
| City | CALEDONIA |
| State | MI |
| Zip Code | 49316-9126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019404 | Melissa Muir Counseling Services Pllc | Psychologist | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2019-02-14 |
| 1043775729 | Larson Dbt Counseling Services Pllc | Psychologist | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2019-02-06 |
| 1508339524 | Clark Institute Psychology Pllc | Psychologist | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2019-01-03 |
| 1194200345 | Clear Visions Counseling | Counselor | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2018-10-03 |
| 1043722176 | Mikids Pediatrics, PC | Pediatrics | 7150 Kalamazoo Ave Se, Suite A, Caledonia, MI 49316 | 2017-10-30 |
| 1225550403 | Wesley Keith Washington | Counselor | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2017-07-10 |
| 1861930158 | Acorn Hill Psychology Pllc | Psychologist | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2017-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407326036 | Daina Elizabeth Graves | Occupational Therapist | 10560 Whispering Waters Ln Se, Caledonia, MI 49316 | 2018-11-27 |
| 1033619135 | Spectrum Health Primary Care Partners | Physical Therapist | 6201 68th St Se, Caledonia, MI 49316 | 2018-02-15 |
| 1538672035 | Justin Michael Keely | Student in an Organized Health Care Education/Training Program | 8441 Sunnyview Rd., Caledonia, MI 49316 | 2017-11-07 |
| 1457614521 | Rahaf Halimeh | Dentist | 3625 Riverbed Lane Se, #3, Caledonia, MI 49316 | 2012-06-22 |
| 1487913158 | Adam Zachary Mitchell | Family Medicine | 9090 S Rodgers Ct Se Ste A, Caledonia, MI 49316 | 2012-05-15 |
| 1841588522 | Oday Ali Kasim | Pharmacist | 9375 Cherry Valley Ave., Caledonia, MI 49316 | 2011-07-15 |
| 1417183344 | Allison Leigh Ford | Physical Therapist | 10047 Cross Road Ct. Se, Suite 150, Caledonia, MI 49316 | 2009-06-05 |
| 1336351741 | Paula Delorm | Physical Therapist | 6595 Gracepoint Dr. Se, Caledonia, MI 49316 | 2007-05-06 |
| 1366532798 | Wayne D Westbrook | Dentist | 3125 68th St Se, Dutton, MI 49316 | 2006-10-14 |
| 1629184056 | Patricia Brunck Cassell | Social Worker | 9090 Sourth Rodgers Court Se, Caledonia, MI 49316 | 2006-08-21 |
| Find all providers in zip 49316 | ||||
| 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 |
|---|---|---|---|---|
| 1639615321 | Jordan Daniel Stricklen | Psychologist | 6505 Cherry Meadow, Caledonia, MI 49316-8052 | 2017-01-18 |
| 1083915276 | Susan Lee Alderink-hulst | Psychologist | 3178 68th St Se, Suite C, Caledonia, MI 49316-7535 | 2010-11-04 |
| 1477019404 | Melissa Muir Counseling Services Pllc | Psychologist | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2019-02-14 |
| 1508339524 | Clark Institute Psychology Pllc | Psychologist | 7150 Kalamazoo Ave Se, Suite C, Caledonia, MI 49316 | 2019-01-03 |
| 1366983082 | Integrative Counseling and Psychological Services LLC | Psychologist | 7199 Kalamazoo Ave Se, Suite 231, Caledonia, MI 49316-7341 | 2017-03-14 |
| 1285818203 | Julie Ellen O'mara Meyer | Psychologist | 511 W Main St, Caledonia, MN 55921-1869 | 2007-12-27 |
| 1154478089 | The Counseling Group LLC | Psychologist | 9021 N Rodgers Ct Se, Suite C, Caledonia, MI 49316-7649 | 2007-01-04 |
| 1861549792 | Dennis R Bourdo II | Psychologist | 9021 N Rodgers Ct Se, Suite C, Caledonia, MI 49316-7649 | 2007-01-04 |
| 1619987740 | Pine Rest Christian Mental Health Services | Psychologist | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
| 1932700036 | Estela M Rivero | Psychologist | 2627 Oak Valley Dr Apt 205, Ann Arbor, MI 48103-7705 | 2020-11-04 |
| 1144829037 | Damon Moore | Psychologist | 15450 E Jefferson Ave Ste 180, Grosse Pointe Park, MI 48230-2031 | 2020-10-21 |
| 1073112355 | Sarah Nicole Kesler | Psychologist | 230 Collingwood St Ste 250, Ann Arbor, MI 48103-3845 | 2020-10-19 |
| 1518564947 | Margaret L Blevins | Psychologist | 21769 Meridian Rd, Grosse Ile, MI 48138-1453 | 2020-10-08 |
| 1770197717 | Susan J Goldberg | Psychologist | 442 Randolph St, Northville, MI 48167-1465 | 2020-09-08 |
| 1255944096 | Eric S. Samson | Psychologist | 2045 E West Maple Rd Ste D405, Commerce Township, MI 48390-3801 | 2020-08-30 |
| 1891308904 | Susan Gottlieb Phd LLC | Psychologist | 23800 Orchard Lake Rd Ste 104, Farmington Hills, MI 48336-2561 | 2020-08-28 |
| 1538784012 | Bethany S Gourley | Psychologist | 19855 Outer Dr Ste 300, Dearborn, MI 48124-2022 | 2020-06-10 |
| 1316560303 | Amy K Pruneau LLC | Psychologist | 26755 Middlebelt Rd Ste 140, Farmington Hills, MI 48334 | 2020-05-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MATTHEW DAVID AYERS CLARK.
| 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.