Individual
DANIEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1133 BROADWAY STE 1127, NEW YORK, NY 10010-7973
(562) 314-1999
(855) 595-2754
Mailing address
1133 BROADWAY STE 1127, NEW YORK, NY 10010-7973
(562) 314-1999
(855) 595-2754
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
025673
NY
103T00000X
Psychologist
11426
MA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
08/29/2018
Last updated
01/26/2026
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