Individual
KERVINS CLEMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMHCAS
Contact information
Practice address
6614 SHALLOWFORD RD STE 250, LEWISVILLE, NC 27023-9305
(336) 945-0137
(336) 946-9084
Mailing address
1547 NEW GARDEN RD APT 2H, GREENSBORO, NC 27410-1550
(239) 324-2837
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26212
NC
101YM0800X
Mental Health Counselor
A15687
NC
Other
Enumeration date
04/02/2020
Last updated
04/24/2020
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