person
Kevin Clark
Addiction (Substance Use Disorder) Counselor in Fairfax, Virginia
NPI 1245851104

Kevin Clark is an Addiction (Substance Use Disorder) Counselor based in Manassas, VA and is specialized in Addiction (Substance Use Disorder). Kevin Clark practices in Fairfax, VA. The NPI Number for Kevin Clark is 1245851104 and holds a License No. 0710103244 (Virginia).

The current practice location address for Kevin Clark is 10615 Judicial Dr Ste 403, Fairfax, VA and can be reached out via phone at 703-565-3783 and via fax at 571-285-4001.

Location: 10615 Judicial Dr Ste 403, Fairfax, VA, 20111-8268
person
Provider Profile Details
NPI Number
1245851104
Provider Name
Kevin Clark
Credential
Provider Entity Type
Individual
Gender
Male
Address
10615 Judicial Dr Ste 403, Fairfax, VA, 20111-8268
Phone Number
703-565-3783
Fax Number
571-285-4001
Provider Enumeration Date
05/01/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
10615 Judicial Dr Ste 403
City
State
Zip
22030-7501
Phone Number
703-565-3783
Fax Number
571-285-4001
person
Provider Business Mailing Address Details
Address
10615 Judicial Dr Ste 403
City
State
Zip
22030-7501
Phone Number
703-565-3783
Fax Number
571-285-4001
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
0710103244 (Virginia)
Definition
Definition to come...
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