Jendaya M. Clark
Counselor · Rockford, IL
Practice location
1201 Cypress TerRockford, IL 61102-3375
- Phone
- (815) 519-8548
NPI record
- NPI
- 1346866563
- Entity type
- Individual (Type 1)
- Enumeration date
- June 23, 2020
- Last updated
- June 23, 2020
- Certified
- June 23, 2020
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor Primary | 101Y00000X |
180.012915 | IL |
Mailing address
PO Box 341Rockford, IL 61105-0341
- Phone
- (815) 519-8548
About Jendaya Clark
Jendaya M. Clark is a healthcare provider registered in the NPI registry with the primary taxonomy Counselor (code 101Y00000X). The practice location is 1201 Cypress Ter, Rockford, IL 61102-3375. The NPI number 1346866563 was assigned on June 23, 2020 and the record was last updated on June 23, 2020.
Jendaya Clark lists a license in the registry: #180.012915 (IL) for Counselor. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Jendaya M. Clark?
The NPI number is 1346866563.
What is the phone number of Jendaya Clark?
The phone number listed for the practice location is (815) 519-8548.
Where is Jendaya Clark located?
1201 Cypress Ter, Rockford, IL 61102-3375.
What is the taxonomy code for Jendaya Clark?
The primary taxonomy code is 101Y00000X – Counselor.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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