MR. CLARK KENT JACKSON (NPI# 1962508192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962508192 |
| Entity Type | Individual |
| Full Name | MR. CLARK KENT JACKSON |
| Credential | MSW |
| Practice Address |
6 S 2nd St Ste 918 Yakima WA 98901-2632 |
| Mailing Address |
2004 E 1st Ave Ellensburg WA 98926-9021 |
| Practice Telephone | 5099618233 |
| Practice Fax Number | 5099622286 |
| Mailing Telephone | 5099334803 |
| Mailing Fax Number | 5099622286 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LW6908 | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053768945 | Clark Jackson | Nurse Anesthetist, Certified Registered | 2500 S 60th St Apt 21, Lincoln, NE 68506-3579 | 2016-05-20 |
| Street Address |
6 S 2ND ST STE 918 |
| City | YAKIMA |
| State | WA |
| Zip Code | 98901-2632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396081683 | Starla D Stone | Social Worker | 6 S 2nd St, Suite 316, Yakima, WA 98901-2632 | 2012-12-14 |
| 1922344217 | Anthony E Stone | Social Worker | 6 S 2nd St, Suite 316, Yakima, WA 98901-2632 | 2012-12-14 |
| 1649520032 | Paraclete Counseling Services, LLC | Social Worker | 6 S 2nd St, Suite 316, Yakima, WA 98901-2632 | 2012-09-13 |
| 1205072451 | Rey Gonzalez Social Work, Pllc | Preferred Provider Organization | 6 S 2nd St, Suite #710, Yakima, WA 98901-2632 | 2008-12-17 |
| 1851562888 | Emily E Shoemaker | Counselor | 6 S 2nd St, Suite 206, Yakima, WA 98901-2632 | 2008-03-18 |
| 1578767349 | Joyce Marie Joy | Social Worker | 6 S 2nd St, Ste 403, Yakima, WA 98901-2632 | 2007-06-13 |
| 1245353200 | Patricia E Byers | Counselor | 6 S 2nd St, Suite 907, Yakima, WA 98901-2632 | 2007-04-06 |
| 1922146752 | Kathleen J Kinkead | Massage Therapist | 6 S 2nd St, Suite 710, Yakima, WA 98901-2632 | 2007-02-02 |
| 1598829368 | Judith Ann Landvoy | Counselor | 6 S 2nd St, Suite 307, Yakima, WA 98901-2632 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162998 | China Nwachukwu | Pharmacist | Buter-haney Hall, 200 University Pkwy, Yakima, WA 98901 | 2020-07-30 |
| 1760959290 | Conswaylo Ann Fleek | Counselor | 120 S. 3rd Ave., Yakima, WA 98901 | 2018-11-02 |
| 1396212718 | Nancy Fraser | Counselor | 120 S. 3rd Street, Yakima, WA 98901 | 2018-10-24 |
| 1386129021 | John Scott | Student in an Organized Health Care Education/Training Program | Pacific Northwest University of Health Sciences, 111 University Parkway, Suite 202, Yakima, WA 98901 | 2018-09-28 |
| 1679051387 | Toni Christine Fogli | Counselor | 2280 Ste. Rte. 821, Yakima, WA 98901 | 2018-08-03 |
| 1043798267 | Amber Ann Couture | Counselor | 2280 Wa-821, Yakima, WA 98901 | 2018-07-31 |
| 1992201982 | Etienne Galbreath | Student in an Organized Health Care Education/Training Program | Butler-haney Hall, 200 University Pkwy, Yakima, WA 98901 | 2018-03-30 |
| 1619490737 | Christine M Armijo | Massage Therapist | 1001 University Parkway, Yakima, WA 98901 | 2017-07-20 |
| 1366970048 | Jose Antonio Mendoza | Dentist | 12 S 8t Hst, Yakima, WA 98901 | 2017-05-25 |
| 1982156501 | David Burkett | Counselor | 315 N. 2nd Street, Yakima, WA 98901 | 2016-10-31 |
| Find all providers in zip 98901 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689218109 | Christopher Dennis Mallonee | Social Worker | 2119 W Lincoln Ave, Yakima, WA 98902-2414 | 2019-10-29 |
| 1164086328 | Julie K Besel | Social Worker | 6402 Morningside Ct, Yakima, WA 98901-7940 | 2019-04-23 |
| 1841682663 | Melissa Renee Walker | Social Worker | 6901 W Acre Ct, Yakima, WA 98903-9585 | 2015-03-03 |
| 1437426293 | Lisa Anne Matthews | Social Worker | 109 N 78th Ave, Yakima, WA 98908-4133 | 2011-11-22 |
| 1275764078 | Susan Scott Lisee | Social Worker | 791 Old Naches Hwy, Yakima, WA 98908-9036 | 2009-07-28 |
| 1760622856 | Avry Eichwald | Social Worker | 6 S 2nd St Ste 200, Yakima, WA 98901-2629 | 2009-03-02 |
| 1780851097 | James Arthur Renner | Social Worker | 6 South 2nd Street, Suite 1008, Yakima, WA 98901 | 2008-05-15 |
| 1801090741 | Lindsey Vaagen | Social Worker | 402 E Yakima Ave Ste 380, Yakima, WA 98901-5410 | 2007-06-13 |
| 1023226065 | Lisa Herr | Social Worker | 412 S 12th Ave, Yakima, WA 98902-3115 | 2007-05-21 |
| 1821213125 | Judith Velma Casey | Social Worker | 1505 S 12th Ave, Yakima, WA 98902-5813 | 2007-04-13 |
| Find all providers in YAKIMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.