JEREMY CLARK
NPI 1851551873
Counselor - Mental Health in Pocatello, ID
Active since June 12, 2008
2055 GARRETT WAY, STE 1, POCATELLO, ID 83201(208) 236-1600(208) 236-6695 Get Directions Write a Review
About Jeremy Clark NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEREMY CLARK (NPI 1851551873) is an individual mental health provider in Pocatello, Idaho and active in the NPI registry since June 2008.
NPPES Registry Identity
NPI1851551873
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJEREMY CLARK
Location Address2055 GARRETT WAY, STE 1Pocatello, ID 83201-5100
Mailing Address2055 Garrett Way, Ste 1Pocatello, ID 83201-5100 · (208) 236-1600 · Fax (208) 236-6695
Phone(208) 236-1600
Fax(208) 236-6695
Sole ProprietorNo
Enumeration DateJune 12, 2008
✔ NPI 1851551873 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
2055 GARRETT WAY, Pocatello, ID 83201
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1851551873, enumerated as an "individual" on June 12, 2008.
The provider is located at 2055 GARRETT WAY STE 1 POCATELLO, ID 83201 and the phone number is (208) 236-1600.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
