Clemens, Misty Jo
Clemens, Misty Jo is an sole proprietor health care provider with primary practice located at 56 S 65Th St Suite 1, Belleville IL 62223-2945. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Clemens, Misty Jo can be contacted via phone (618) 795-7608.Contact Information
Primary practice address
56 S 65Th St Suite 1
Belleville IL 62223-2945
Phone: (618) 795-7608
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 180.006844 | Illinois |
Profile Details
| NPI number | 1396021069 |
|---|---|
| LBN Legal business name | Clemens, Misty Jo |
| Credentials | M.A., LCPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 26th, 2011 |
| Last updated | Oct 26th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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