Individual provider · Type 1 NPI
Kevin Lee Clark Jr., LCAS-A
Addiction (Substance Use Disorder) Counselor · Southern Pines, NC
NPI number
1417496829
Active
Practice location
150 Boiling Springs Cir
Southern Pines, NC 28387-3306
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | LCAS-30345 (NC) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1417496829
Kevin Lee Clark Jr., LCAS-A's National Provider Identifier is 1417496829, issued on Feb 17, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Southern Pines, NC. The record was last updated on Jun 25, 2025.