Individual
MR. KEVIN LEE CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
150 BOILING SPRINGS CIR, SOUTHERN PINES, NC 28387-3306
(910) 690-2803
Mailing address
150 BOILING SPRINGS CIR, SOUTHERN PINES, NC 28387-3306
(910) 690-2803
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-30345
NC
Other
Enumeration date
02/17/2017
Last updated
06/25/2025
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