Provider Demographics
NPI:1629493457
Name:CLARE, JENNIFER (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CLARE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 ROLLING RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-9694
Mailing Address - Country:US
Mailing Address - Phone:706-237-9849
Mailing Address - Fax:
Practice Address - Street 1:6520 ROLLING RIVER RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-9694
Practice Address - Country:US
Practice Address - Phone:706-237-9849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0063791041C0700X, 1041C0700X
TNLSW00000069051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical