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Deactivated NPI 1235432659 Deactivated / Inactive NPI Male Practitioner

Stephen E Clark , LP, LMFT

Psychologist • Edina, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Stephen Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 07, 2010
NPI Deactivation Date February 08, 2023
Total Practice Duration ~13 Years of Practice (2010 – 2023)

Professional Overview & Biography Verified Profile Summary

Stephen Clark, LP, LMFT was a registered Psychologist practicing in Edina, MN. Throughout an active medical career spanning 13 years, Stephen Clark provided care at the practice location at 6550 YORK AVE S until profile deactivation on 2023-02-08.

Practice Location & Contact Primary Location

Practice Address

6550 York Ave S
Ste 503

Edina, MN 55435

Telephone 9529293103
Fax 9529298038
Associated Practice Facility / Clinic
🏢 Club Recovery Llc Facility NPI 1023032703

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Edina, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.4 Yrs
State Avg: 22.6 Yrs
Regional Practice Density
68 Specialists

Practicing in Edina, MN (1833 Statewide)

Telehealth Adoption Rate
10.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MN 1027

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1225133358

Licensed Marriage and Family Therapist

Joyce Popp , LP

Psychologist - Counseling

NPI 1407127517

Licensed Psychologist

Bryan Kingsriter , LICSW, LMFT

Social Worker - Clinical

NPI 1407951544

Licensed Independent Clinical Social Worker, Licensed Marriage and Family Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 08, 2023

Record deactivated on February 08, 2023

NPI Profile Active December 07, 2010

NPI status registered as active in NPPES database

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Updated Practice Location December 07, 2010

Registered at 6550 YORK AVE S, STE 503, EDINA, MN 55435 (Tel: 9529293103)

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Updated Business Mailing Address December 07, 2010

Registered at 6132 RIDGEWAY RD, EDINA, MN 554362546 (Tel: 9529137901)

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Provider Name / Credentials Updated December 07, 2010

Recorded as STEPHEN CLARK, LP,LMFT

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 07, 2010

Psychologist (License #1027 in MN)

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Initial NPI Registration & Enumeration December 07, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235432659
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 07, 2010
Last Update: December 07, 2010
Deactivation Date: February 08, 2023

Mailing Address

6132 Ridgeway Rd

Edina, MN 554362546

Phone: 9529137901

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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