NPI Profile for JENISE T CLARK in FAYETTEVILLE, GA.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Counselor |
101Y00000X | |||
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1851880926 |
|
| Status | Active | |
| Credentials | LPC (Licensed Professional Counselor) | |
| Entity | Individual | |
| Enumeration date | 05/04/2018 | |
| Last updated | 03/22/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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JENISE T CLARK
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