MR. KEVIN LEE CLARK JR. LCAS-A
NPI 1417496829
Counselor - Addiction (Substance Use Disorder) in Southern Pines, NC

Q: What is Kevin Clark's NPI number?

The NPI number for Kevin Clark is 1417496829. It was assigned to this individual provider in the NPPES registry on February 17, 2017.

Q: What is Kevin Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Clark was last updated on June 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.

Active since February 17, 2017

150 BOILING SPRINGS CIR, SOUTHERN PINES, NC 28387(910) 690-2803 Get Directions Write a Review

NPPES record last updated: June 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 25, 2025, Feb 17, 2017 (2 updates tracked since 2017).

On this page

About Mr. Kevin Lee Clark Jr. Lcas-a NPPES

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

MR. KEVIN LEE CLARK JR. LCAS-A (NPI 1417496829) is an individual addiction (substance use disorder) provider in Southern Pines, North Carolina, licensed in North Carolina (LCAS-30345) and active in the NPI registry since February 2017.

NPPES Registry Identity

NPI1417496829

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMR. KEVIN LEE CLARK JR.Credential: LCAS-A

Location Address150 BOILING SPRINGS CIRSouthern Pines, NC 28387-3306

Mailing Address150 Boiling Springs CirSouthern Pines, NC 28387-3306 · (910) 690-2803

Phone(910) 690-2803

Sole ProprietorNo

Enumeration DateFebruary 17, 2017

Last NPPES UpdateJune 25, 20252 updates tracked since enumeration

NPPES CertifiedJune 25, 2025

✔ NPI 1417496829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in NC · LCAS-30345

150 BOILING SPRINGS CIR, Southern Pines, NC 28387

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

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 Kevin Clark's NPI number?

The NPI number for Kevin Clark is 1417496829. It was assigned to this individual provider in the NPPES registry on February 17, 2017.

Where is Kevin Clark located?

Kevin Clark practices at 150 Boiling Springs Cir, Southern Pines, NC 28387. The listed phone number is (910) 690-2803.

What is Kevin Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

What insurance does Kevin Clark accept?

Health plans from Blue Cross and Blue Shield of NC list Kevin Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Clark was last updated on June 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.