Ja'Cole Clark
Individual provider Active NPI Mental Health Counselor · Crowley, TX
NPI 1639614423 · NPPES record last updated Jan 3, 2017
Key facts
- NPI
- 1639614423
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 10244 E Rancho Diego LN
Crowley, TX 76036-9434 - Phone
- (817) 944-3213
- NPI assigned
- Jan 3, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
10244 E Rancho Diego LN
Crowley, TX 76036-9434
Mailing address
10244 E Rancho Diego LN
Crowley, TX 76036-9434
Other providers in Crowley, TX
- Portia Lavonne Chambers
- Shemila S. Chancellor
- Chisholm Trail Mentalhealth and Therapy Services PLLC
- City of Crowley
- CJR Empowered Living Homes
- Janice L Clark
- Janice Cobrand
- Jada Coburn
- Betty Colbert
- Lorene Collier Purcy
All providers in Crowley, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.