CLARISSA ROSALEE JOLLY TCADC NPI 1073291902

NPI Information

  • NPI: 1073291902
  • Provider Name: CLARISSA ROSALEE JOLLY, TCADC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 3640 CANTERBURY CT
    WATERLOO, IA
    ZIP 50702
  • Phone: (319) 252-4631

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NPI Details

Clarissa Rosalee Jolly, TCADC is an addiction (substance use disorder) counselor in Waterloo, IA. Clarissa Rosalee Jolly, TCADC NPI is 1073291902. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3640 CANTERBURY CT
WATERLOO, IA
ZIP 50702-705
Phone: (319) 252-4631
Fax: (319) 209-9287

The enumeration date for this NPI number is 7/10/2023 and was last updated on 7/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)23055IOWAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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