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Individual
MS. JESSICA A CLARK
Active
Individual
MS. JESSICA A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
828
NE
101YM0800X
Mental Health Counselor
Primary
193
NE
101YM0800X
Mental Health Counselor
3075
NE
1041C0700X
Clinical Social Worker
1204
NE
1041C0700X
Clinical Social Worker
4823
SD
Other
Enumeration date
09/29/2006
Last updated
06/18/2018
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