JACQUELYN CLEMONS LLBSW
NPI 1417476151
Student in an Organized Health Care Education/Training Program in Ecorse, MI

Active since September 13, 2017

NPPES record last updated: September 13, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jacquelyn Clemons Llbsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYN CLEMONS LLBSW (NPI 1417476151) is an individual student in an organized health care education/training program in Ecorse, Michigan and active in the NPI registry since September 2017.

NPPES Registry Identity

NPI1417476151
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJACQUELYN CLEMONSCredential: LLBSW
Location Address4300 6TH STEcorse, MI 48229-1110
Mailing Address9348 Tobine StRomulus, MI 48174-3365 · (313) 285-0156
Sole ProprietorYes
Enumeration DateSeptember 13, 2017
NPI 1417476151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4300 6TH ST, Ecorse, MI 48229

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417476151, enumerated as an "individual" on September 13, 2017.

The provider is located at 4300 6TH ST ECORSE, MI 48229 and the phone number is (313) 724-6192.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.