Individual
JASON MATTHEW CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
9869 PULASKI PIKE STE C, TONEY, AL 35773-7201
(256) 850-4091
(256) 970-1643
Mailing address
9869 PULASKI PIKE STE C, TONEY, AL 35773-7201
(256) 850-4091
(256) 975-1643
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5478C
AL
Other
Enumeration date
11/06/2023
Last updated
11/09/2025
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