Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KEVIN CLARK
Active Sole ProprietorKEVIN CLARK is a Addiction (Substance Use Disorder) Counselor healthcare provider located in FAIRFAX, Virginia. NPI 1245851104 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · FAIRFAX, VA
Registration Details
- NPI Number
- 1245851104
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 1, 2020 (6.3323674562656 yrs)
- Last Updated
- Apr 26, 2021
- License
-
0710103244 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
10615 JUDICIAL DR STE 403FAIRFAX, VA, 220307501Browse VA providers · Browse ZIP 22030
- Phone
- 7035653783
- Fax
- 5712854001
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in FAIRFAX, VA
| Name | Credential | NPI |
|---|---|---|
| MS. GAIL W CAMPBELL | LPC, LSATP | 1932121290 |
| DAVID ALAN JACOBS | LPC | 1609898154 |
| MRS. SANDRA LOUISE LOPEZ | LPC | 1356400469 |
| MR. JOHN E CLARK III | — | 1699824763 |
| MS. SUSAN R ALLEN | CAC | 1720102817 |
| MR. EDWARD MICHAEL ANDREWS | LPC, LMFT, NCC | 1972620177 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.