CHRISTINA CLARK – Clinical Psychologist, NPI 1003817081

CHRISTINA CLARK is a healthcare provider. based in Worthington, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. 5317 (OH). The NPI Number for CHRISTINA CLARK is 1003817081

Main info

Female
Sole Proprietor
30 Years Of Experience
Accepts Medicare Assignment
Name
CHRISTINA CLARK
NPI
1003817081
Phone
(614) 430-8920
Address
666 HIGH ST
Enumeration Date
2 August 2005
Last Update Date
28 September 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6144308920
Graduation Year
1996 (30 years ago)
PAC ID
5597785121
Professional Enrollment ID
I20051129000096
Address ID
OH430854135WO666XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

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Provider Addresses for CHRISTINA CLARK

  • 666, High Street, Olde Towne Commons, Portsmouth, Virginia, 23704, United States

    SUITE 200-D

    WORTHINGTON, OH 430854135

    Phone: (614) 430-8920

    Fax: (614) 430-8920

    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: 2005-11-29

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
I20051129000096IClinical PsychologistOHTBD

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 43085)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for CHRISTINA CLARK?
CHRISTINA CLARK — NPI 1003817081 — is the standard way to identify this listing.
Is CHRISTINA CLARK listed as active for patients and plans?
The listing shows CHRISTINA CLARK as active in the NPI system.
What taxonomy line describes CHRISTINA CLARK?
For research purposes, treat CHRISTINA CLARK as Clinical Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
What area does CHRISTINA CLARK serve?
CHRISTINA CLARK's listing highlights Worthington, Ohio; more addresses can appear in NPPES.
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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