# DR. KEVIN CLARK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1265736508
- **Gender:** Man
- **Credential:** DAOM, LAC, NCC, EMDR

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 2025-000205 | NJ | — |
| 101YP2500X | Professional Counselor | 37AC00916700 | NJ | — |
| 171100000X | Acupuncturist | 25MZ00104200 | NJ | Yes |
| 171100000X | Acupuncturist | CQ-0000029 | DE | — |

## Other

- **Enumeration date:** 12/30/2010
- **Last updated:** 10/31/2025