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

Mr. Kevin Lee Clark Jr., LCAS-A

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1417496829

Mr. Kevin Lee Clark Jr., LCAS-A is an Addiction (Substance Use Disorder) Counselor in Southern Pines, North Carolina. Licensed in North Carolina. Registered with an NPI since 2017.

Licensed in
NC
In the registry since
2017

Practice location Address checks out

150 Boiling Springs Cir
Southern Pines, NC 28387-3306
Phone: (910) 690-2803
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-30345 (NC)

Record details

NPI number1417496829
Entity typeIndividual (Type 1)
GenderMale
Credentials LCAS-A
Sole proprietorNo
NPI enumeratedFebruary 17, 2017
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025

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