Individual provider · Type 1 NPI

Jason Clark

Mental Health Counselor · Chicago, IL

NPI number 1033727425 Active

Practice location

2451 N Lincoln Ave Side 2
Chicago, IL 60614-4170

Call (773) 469-6675 Map

Mailing address

1166 Silverwood Ct Apt D1
Wheeling, IL 60090-2431

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1033727425

Jason Clark's National Provider Identifier is 1033727425, issued on Jul 21, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chicago, IL. The record was last updated on Jul 21, 2020.