Individual provider · Type 1 NPI

Stacy Ann Clark

Mental Health Counselor · Jackson, MS

NPI number 1669012647 Active

Practice location

460 Briarwood Dr Ste 510
Jackson, MS 39206-3057

Fax (601) 956-4817

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1669012647

Stacy Ann Clark's National Provider Identifier is 1669012647, issued on Jan 8, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jackson, MS. The record was last updated on Jan 8, 2020.