Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Blake Clarke, LCAS

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1720458615

Jonathan Blake Clarke, LCAS is an Addiction (Substance Use Disorder) Counselor in Southport, North Carolina. Licensed in North Carolina. Registered with an NPI since 2015.

Licensed in
NC
In the registry since
2015

Practice location Address checks out

1529 Shepard Rd SE
Southport, NC 28461-9435
Phone: (704) 249-4231
Fax: (828) 544-1201
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LCAS-2729 (NC)

Record details

NPI number1720458615
Entity typeIndividual (Type 1)
GenderMale
Credentials LCAS
Sole proprietorNo
NPI enumeratedOctober 5, 2015
Last updated in NPPESDecember 6, 2023
Certification dateDecember 6, 2023

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