Jason Clark
Jason Clark is a Mental Health Counselor in Chicago, Illinois. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
2451 N Lincoln Ave Side 2Chicago, IL 60614-4170
Phone: (773) 469-6675
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1033727425 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 21, 2020 |
| Last updated in NPPES | July 21, 2020 |
| Certification date | July 21, 2020 |
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