JERRY CLARK, SUDR, CPC, AAC

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1497232060

Practice Address

1616 S GOLD ST STE 4
Centralia, WA 98531

Phone: (360) 807-4929

Specialties

Specialty Code Primary License
Peer Specialist 175T00000X No -
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes CP61099597 (WA)

Frequently Asked Questions

NPI 1497232060 is the National Provider Identifier for JERRY CLARK, SUDR, CPC, AAC, a Counselor - Addiction (Substance Use Disorder) provider located in Centralia, WA. This NPI was enumerated on July 25, 2018.
JERRY CLARK, SUDR, CPC, AAC practices at 1616 S GOLD ST STE 4, Centralia, WA 98531.

Quick Facts

NPI
1497232060
Type
Individual
Enumerated
Jul 25, 2018
Last Updated
Nov 13, 2020

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