Jaedah Clark, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801104040 Issued in MI

Practice address

250 Monroe Ave NW Ste 400
Grand Rapids, MI 49503-2293

Phone

(616) 329-3511

NPI assigned

Apr 3, 2019

Last updated

Jan 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Love Yours Counseling and Consultation, PLLC

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1588477434
  NPD Authorized official
• County of Washtenaw

  dba Washtenaw county Public Health

  • State or Local Public Health Clinic/Center
  • Ypsilanti, MI
  • NPI 1609896018
  NPD (past)
• County of Washtenaw

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ypsilanti, MI
  • NPI 1639132442
  NPD (past)
• Hope Restored Counseling Center LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1588225882
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1184186660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MONROE AVE NW STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MONROE AVE NW STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032293",
            "telephone_number": "616-329-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAEDAH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851104040",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801104040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Clark
• Eve Clark
• Fanchon Marie Clark, M.A., LPC, CAADC
• Frederick Clark
• Haley L Clark, DMD
• Jamillah D Clark
• Janelle Clark
• Jeff Alberto Clark, MD
• Justin Charles Clark, MD
• Katheryn Elisabeth Clark, CNM

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.