Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Bruce E Clark, PHD

Individual provider Clinical Psychologist · NPI 1669212395

Dr. Bruce E Clark, PHD is a Clinical Psychologist in St Louis Park, Minnesota. Qualified in 2022, 4 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2024
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone: (952) 993-3123
Fax: (952) 993-3286
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3366 Oakdale Ave N Ste 315, Robbinsdale, MN 55422-2967 — (763) 581-5372

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence LP7036 (MN)
Clinical Psychologist Taxonomy 103TC0700X · Licence LP7036 (MN)

Record details

NPI number1669212395
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedMay 30, 2024
Last updated in NPPESAugust 9, 2024
Certification dateAugust 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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