Jessica Clark, BA
Individual provider Active NPI Case Management Agency · Mt Washington, KY
NPI 1942612296 · NPPES record last updated May 21, 2014
Key facts
- NPI
- 1942612296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Agency 251B00000X
- Practice address
- 620 John Austin LN
Mt Washington, KY 40047-6354 - Phone
- (502) 377-2686
- NPI assigned
- May 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Yes |
Addresses
Primary practice location
620 John Austin LN
Mt Washington, KY 40047-6354
Mailing address
620 John Austin LN
Mt Washington, KY 40047-6354
Other providers in Mt Washington, KY
- Cortney L Buse
- Cardiovascular Associates PSC
- Judy Ann Chandler
- Childhood Development Specialists, PLLC
- Madison Chumbler
- Commonwealth of Kentucky
- Tessa Conlin
- Lacey Anne Conway
- Jamie Cox
- Valerie Lynn Crume
All providers in Mt Washington, KY · Case Management Agency in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2014. 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.