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NPI Profile for Dr ROGER G CLARK in FORT CAMPBELL, KY.
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prescribing (Medical) |
103TP0016X | 62 | Psychologist, Clinical | |
Psychologist |
103T00000X | 62 | Psychologist, Clinical |
| NPI Number | 1669501136 |
|
| Status | Active | |
| Credentials | PSY.D. (Doctor of Psychology) | |
| Entity | Individual | |
| Enumeration date | 03/02/2007 | |
| Last updated | 05/31/2023 - About 3 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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ROGER G CLARK
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ROGER G CLARK, PSY.D.