Jennifer R Clark, is a
Counselor based in Wentworh, North Carolina. Jennifer R Clark is licensed to practice in North Carolina (license number P006015) and her current practice location is
405 Nc Hwy 65, Wentworh, North Carolina. She can be reached at her office (for appointments etc.) via phone at
(336) 342-8316.
NPI number for Jennifer R Clark is 1871807560 and her current mailing address is 284 Executive Park, Suite 100, Concord, North Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1871807560.
Healthcare Provider's Profile
Full Name | Jennifer R Clark |
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Gender | Female |
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Speciality | Counselor |
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Location | 405 Nc Hwy 65, Wentworh, North Carolina |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1871807560
- Provider Enumeration Date: 08/05/2010
- Last Update Date: 08/05/2010
Medical Identifiers
Medical identifiers for Jennifer R Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1871807560 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | P006015 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer R Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jennifer R Clark, 284 Executive Park, Suite 100, Concord, NC 28025-1894 Ph: (704) 939-1118 | Jennifer R Clark, 405 Nc Hwy 65, Wentworh, NC 27375-0355 Ph: (336) 342-8316 |
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