Individual provider · Type 1 NPI

Jerome Clark

Mental Health Counselor · Waukegan, IL

NPI number 1013465145 Active

Practice location

671 S Lewis Ave
Waukegan, IL 60085-6101

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1013465145

Jerome Clark's National Provider Identifier is 1013465145, issued on Sep 19, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Waukegan, IL. The record was last updated on Sep 19, 2016.