Provider Information for 1265782254
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
JAMIE M CLARK LMHC, LCPC, SUDP
Sex: Female
NPI: 1265782254
Last Updated: 2024-10-23
Certification Date: 2024-10-23
Certification Date: 2024-10-23
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1265782254 | ||||||||||||||||
| Enumeration Date | 2012-09-17 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1923 N LOCUST RD SPOKANE VLY, WA 99206-4149 United States Phone: 509-953-3692 | Fax: | ||||||||||||||||
| Primary Practice Address | 1923 N LOCUST RD SPOKANE VLY, WA 99206-4149 United States Phone: 509-953-3692 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||
| Other Identifiers |
| ||||||||||||||||
| Taxonomy |
|