Provider Demographics
NPI:1447145982
Name:CLARKE, JAMIE LYNN (MSW)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:CLARKE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 S WATER TOWER PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-6589
Mailing Address - Country:US
Mailing Address - Phone:618-472-2212
Mailing Address - Fax:618-244-0535
Practice Address - Street 1:3600 S WATER TOWER PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6589
Practice Address - Country:US
Practice Address - Phone:618-472-2212
Practice Address - Fax:618-244-0535
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker