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Mr. Kelvin D Clark, MS,LMFT,LPC,LCAS
Marriage & Family Therapist in Fayetteville, North Carolina
NPI 1033165923

Kelvin D Clark is a Marriage & Family Therapist based in Sanford, NC. Kelvin D Clark practices in Fayetteville, NC and has the professional credentials of MS,LMFT,LPC,LCAS. The NPI Number for Kelvin D Clark is 1033165923 and holds a License No. 448 (North Carolina).

The current practice location address for Kelvin D Clark is 1500 Bragg Blvd, Fayetteville, NC and can be reached out via phone at 910-323-1065 and via fax at 910-323-1144. You can also correspond with Kelvin D Clark through the mailing address at 3805 WOODSIDE DR, SANFORD, NC - 27332-8110 (mailing address contact number: 919-776-0399).

Location: 1500 Bragg Blvd, Fayetteville, NC, 27332-8110
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033165923
Provider Name
Kelvin D Clark
Credential
MS,LMFT,LPC,LCAS
Provider Entity Type
Individual
Gender
Male
Address
1500 Bragg Blvd, Fayetteville, NC, 27332-8110
Phone Number
910-323-1065
Fax Number
910-323-1144
Provider Enumeration Date
05/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14762257 01 NC UNITED HEALTHCARE
1002X 01 NC BLUE CROSS PROVIDER
6102267 05 NC
11367606 01 NC CAQH
institution
Provider Business Practice Location Address Details
Address
1500 Bragg Blvd
City
Fayetteville
State
North Carolina
Zip
28301-4289
Phone Number
910-323-1065
Fax Number
910-323-1144
person
Provider Business Mailing Address Details
Address
3805 Woodside Dr
City
Sanford
State
North Carolina
Zip
27332-8110
Phone Number
919-776-0399
Fax Number
910-323-1144
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
448 (North Carolina)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
(North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Marriage & Family Therapist
Speciality
-
Taxonomy
106H00000X
License No.
448 (North Carolina)
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
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