JUSTIN CLARK BA HISTORY
NPI 1114360807
Developmental Therapist in Southern Pines, NC

Active since April 11, 2013
1280 CENTRAL DR, SOUTHERN PINES, NC 28387(910) 692-3323(910) 692-1114 Get Directions Write a Review

NPPES record last updated: April 11, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Justin Clark Ba History NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN CLARK BA HISTORY (NPI 1114360807) is an individual developmental therapist in Southern Pines, North Carolina and active in the NPI registry since April 2013.

NPPES Registry Identity

NPI1114360807
Entity TypeIndividualMale
Primary Taxonomy222Q00000X
Provider Legal NameJUSTIN CLARKCredential: BA HISTORY
Location Address1280 CENTRAL DRSouthern Pines, NC 28387-2102
Mailing Address1280 Central DrSouthern Pines, NC 28387-2102 · (910) 692-3323 · Fax (910) 692-1114
Fax(910) 692-1114
Sole ProprietorNo
Enumeration DateApril 11, 2013
NPI 1114360807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDevelopmental TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code222Q00000X
Definition
A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development.
1280 CENTRAL DR, Southern Pines, NC 28387

Other Identifiers 1

Medicaid8300012NC

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Developmental Disabilities)
1280 CENTRAL DR
SOUTHERN PINES, NC 28387
Developmental Therapist
1280 CENTRAL DR
SOUTHERN PINES, NC 28387
Developmental Therapist
1280 CENTRAL DR
SOUTHERN PINES, NC 28387
Developmental Therapist
1280 CENTRAL DR
SOUTHERN PINES, NC 28387
Developmental Therapist
1280 CENTRAL DR
SOUTHERN PINES, NC 28387
Developmental Therapist
1280 CENTRAL DR
SOUTHERN PINES, NC 28387
Developmental Therapist
1280 CENTRAL DR
SOUTHERN PINES, NC 28387

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Clark's NPI number?

The NPI number for Justin Clark is 1114360807. It was assigned to this individual provider in the NPPES registry on April 11, 2013.

Where is Justin Clark located?

Justin Clark practices at 1280 Central Dr, Southern Pines, NC 28387. The listed phone number is (910) 692-3323.

What is Justin Clark's specialty?

The primary specialty registered for this NPI is Developmental Therapist with taxonomy code 222Q00000X.

When was this NPI record last updated?

The NPPES record for Justin Clark was last updated on April 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.