Individual provider · Type 1 NPI

Jendaya M. Clark

Counselor · Rockford, IL

NPI number 1346866563 Active

Practice location

1201 Cypress Ter
Rockford, IL 61102-3375

Call (815) 519-8548 Map

Mailing address

PO Box 341
Rockford, IL 61105-0341

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000X180.012915 (IL)

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1346866563

Jendaya M. Clark's National Provider Identifier is 1346866563, issued on Jun 23, 2020. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Rockford, IL. The record was last updated on Jun 23, 2020.