MR. JEFFERY DUANE CLARK LICSWA SUDP NPI 1225539570

NPI Information

NPI: 1225539570
Provider Name: MR. JEFFERY DUANE CLARK, LICSWA, SUDP
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
628 S COWLEY ST
SPOKANE, WA
ZIP 99202
Phone: (509) 624-3227
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MR. Jeffery Duane Clark, LICSWA, SUDP is a mental health counselor in Spokane, WA. MR. Jeffery Duane Clark, LICSWA, SUDP NPI is 1225539570. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

628 S COWLEY ST
SPOKANE, WA
ZIP 99202-377
Phone: (509) 624-3227

The enumeration date for this NPI number is 2/22/2018 and was last updated on 5/19/2022.

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
1	101YM0800X	Counselor	Mental Health	SC60981928	WASHINGTON	Yes
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CP61031972	WASHINGTON	No

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: 4/28/2024

NPI Synchronization or Removal

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