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Individual
DR. KEVIN CLARK
Active
Individual
DR. KEVIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DAOM, LAC, NCC, EMDR
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2025-000205
NJ
101YP2500X
Professional Counselor
37AC00916700
NJ
171100000X
Acupuncturist
Primary
25MZ00104200
NJ
171100000X
Acupuncturist
CQ-0000029
DE
Other
Enumeration date
12/30/2010
Last updated
10/31/2025
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