Evette Jackson Clark, is a
Case Manager/care Coordinator based in Cleveland, Ohio. Evette Jackson Clark is licensed to practice in * (Not Available) (license number ) and her current practice location is
10613 Dove Ave, Cleveland, Ohio. She can be reached at her office (for appointments etc.) via phone at
(216) 337-5597.
NPI number for Evette Jackson Clark is 1316432511 and her current mailing address is 10613 Dove Ave, Cleveland, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1316432511.
Healthcare Provider's Profile
| Full Name | Evette Jackson Clark |
|---|
| Gender | Female |
|---|
| Speciality | Case Manager/care Coordinator |
|---|
| Location | 10613 Dove Ave, Cleveland, Ohio |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1316432511
- Provider Enumeration Date: 06/29/2018
- Last Update Date: 01/15/2026
Medical Identifiers
Medical identifiers for Evette Jackson Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316432511 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (Ohio) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
| 172V00000X | Community Health Worker | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evette Jackson Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Evette Jackson Clark,
10613 Dove Ave,
Cleveland, OH 44105-4235
Ph: (216) 337-5597 | Evette Jackson Clark,
10613 Dove Ave,
Cleveland, OH 44105-4235
Ph: (216) 337-5597 |
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