Kevin John Clark
Counselor, Mental Health in Brooklyn, NY. Individual provider (NPI-1).
NPI number1609934397
StatusActive
Last updated in NPPESNov 7, 2024
Details
- NPI
- 1609934397
- Entity type
- Individual (NPI-1)
- Name
- Kevin John Clark
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 5, 2006
- Certification date
- Nov 7, 2024
- Last updated
- Nov 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 000087 | NY | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
32 Court StBrooklyn, NY 11201-4421
Phone 718-648-0705 · Fax 347-333-3451
Mailing address
47 Cambridge DrJackson, NJ 08527-2641
Phone 718-648-0705 · Fax 732-363-5983
Other practice locations
32 Court St
Brooklyn, NY 11201-4421
Brooklyn, NY 11201-4421
Phone 718-648-0705 · Fax 347-333-3451
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