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Individual
MRS. VALERIE JORDAN CLARK
Active
Individual
MRS. VALERIE JORDAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003751
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010264359
VIRGINIA PREMIER HEALTH
VA
05
—
010264359
—
VA
01
—
197565
ANTHEM BLUE CROSS BLUE SH
VA
01
—
O802295M
SENTARA-OPTIMA-OFC
VA
Enumeration date
07/05/2006
Last updated
04/25/2009
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