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Individual

JENNA MICHELLE CLARKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
415 GLENSPRINGS DR STE 201, CINCINNATI, OH 45246-2353
(513) 904-5075
Mailing address
415 GLENSPRINGS DR STE 201, CINCINNATI, OH 45246-2353
(513) 904-5075

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
S.2004723
OH
1041C0700X
Clinical Social Worker
Primary
I.2204168
OH
171M00000X
Case Manager/Care Coordinator
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0391468
OH
Enumeration date
12/06/2019
Last updated
05/02/2023
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