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Jayson Clark, MSMFT,LPC
Professional Counselor in Roseburg, Oregon
NPI 1598198954

Jayson Clark is a Professional Counselor based in Roseburg, OR and is specialized in Professional. Jayson Clark practices in Roseburg, OR and has the professional credentials of MSMFT,LPC. The NPI Number for Jayson Clark is 1598198954 and holds a License No. T-17-081 (Oregon).

The current practice location address for Jayson Clark is 621 W Madrone St, Roseburg, OR and can be reached out via phone at 541-672-2691. You can also correspond with Jayson Clark through the mailing address at PO BOX 1121, ROSEBURG, OR - 97470-0254 (mailing address contact number: ).

Location: 621 W Madrone St, Roseburg, OR, 97470-0254
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Provider Profile Details
NPI Number
1598198954
Provider Name
Jayson Clark
Credential
MSMFT,LPC
Provider Entity Type
Individual
Gender
Male
Address
621 W Madrone St, Roseburg, OR, 97470-0254
Phone Number
541-672-2691
Fax Number
Provider Enumeration Date
08/20/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500725582 05 OR
500714629 05 OR
institution
Provider Business Practice Location Address Details
Address
621 W Madrone St
City
State
Zip
97470
Phone Number
541-672-2691
Fax Number
person
Provider Business Mailing Address Details
Address
621 W Madrone St
City
State
Zip
97470
Phone Number
541-672-2691
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
C5596 (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
T-17-081 (Oregon)
Definition
Definition to come...
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