JERRY DEAN CLARK (SUDR, CPC, AAC) – Addiction (Substance Use Disorder) Counselor, NPI 1497232060

Addiction (Substance Use Disorder) Counselor

JERRY DEAN CLARK (SUDR, CPC, AAC) is a healthcare provider. based in Longview, Washington. specializing in Addiction (Substance Use Disorder) Counselor. They hold the professional credentials SUDR, CPC, AAC. They hold a License No. CG60783169 (WA). The NPI Number for JERRY DEAN CLARK (SUDR, CPC, AAC) is 1497232060

Main info

Male

Name

JERRY DEAN CLARK (SUDR, CPC, AAC)

NPI

1497232060

Phone

(360) 200-5419

Address

PO BOX 2394

Enumeration Date

25 July 2018

Last Update Date

13 November 2020

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience47

Completeness75

Years active:7State licenses:2Digital endpointsOther names

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Provider Addresses for JERRY DEAN CLARK (SUDR, CPC, AAC)

PO BOX 2394
LONGVIEW, WA 98632
Phone: (360) 200-5419
Fax: (360) 200-6736
Type: Mailing
South Gold Street, Centralia, Lewis County, Washington, 98531-4320, United States
CENTRALIA, WA 985318930
Phone: (360) 807-4929
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98632)

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Reviews

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Frequently asked questions

Is there an official ID for JERRY DEAN CLARK (SUDR, CPC, AAC) in U.S. healthcare records?

The official identifier for JERRY DEAN CLARK (SUDR, CPC, AAC) is NPI 1497232060.

Is JERRY DEAN CLARK (SUDR, CPC, AAC) shown as active in public data?

Registry records indicate JERRY DEAN CLARK (SUDR, CPC, AAC) maintains an active NPI.

What clinical focus is listed for JERRY DEAN CLARK (SUDR, CPC, AAC)?

At a glance, JERRY DEAN CLARK (SUDR, CPC, AAC) is tied to Addiction (Substance Use Disorder) Counselor. Clinical services aligned with this taxonomy classification.

Is JERRY DEAN CLARK (SUDR, CPC, AAC) located near Longview?

JERRY DEAN CLARK (SUDR, CPC, AAC) currently maps to Longview, Washington in this extract.

What does 2 location(s) imply?

2 practice locations appear in the available data.