DR. THOMAS R CLARK (PH.D.) – Clinical Psychologist, NPI 1407866981

DR. THOMAS R CLARK (PH.D.) is a healthcare provider. based in Northville, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 6301001244 (MI). The NPI Number for DR. THOMAS R CLARK (PH.D.) is 1407866981

Main info

Male
Sole Proprietor
54 Years Of Experience
Accepts Medicare Assignment
Name
DR. THOMAS R CLARK (PH.D.)
NPI
1407866981
Phone
(248) 349-3131
Address
41820 6 MILE RD
Enumeration Date
8 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2483493131
Graduation Year
1972 (54 years ago)
PAC ID
0749284594
Group Practice PAC ID
5395749147
Professional Enrollment ID
I20080530000782
Address ID
MI481682771NO41820RDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,216 CLINICAL PSYCHOLOGIST in MI

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Provider Addresses for DR. THOMAS R CLARK (PH.D.)

  • 7 Mile Road, Northville, Wayne County, Michigan, 18167, United States

    SUITE 104

    NORTHVILLE, MI 481682763

    Phone: (248) 349-3131

    Fax: (248) 349-3232

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-05-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080530000782IClinical PsychologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48168)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395749147View full group profile
NameSpecialtyState
Clinical PsychologistMI
Clinical PsychologistMI

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Frequently asked questions

How is DR. THOMAS R CLARK (PH.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. THOMAS R CLARK (PH.D.) with NPI 1407866981.
Is DR. THOMAS R CLARK (PH.D.) listed as active for patients and plans?
The listing shows DR. THOMAS R CLARK (PH.D.) as active in the NPI system.
What is DR. THOMAS R CLARK (PH.D.) best known for clinically?
Directory data describes DR. THOMAS R CLARK (PH.D.) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does DR. THOMAS R CLARK (PH.D.) list a practice location?
Patients near Northville, Michigan may find DR. THOMAS R CLARK (PH.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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