Healthcare Provider Details

I. General information

NPI: 1346531365
Provider Name (Legal Business Name): STEVEN LLOYD CLEMONS JR. LCMHCS, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10643 KETTERING DRIVE SUITE 108
CHARLOTTE NC
28226
US

IV. Provider business mailing address

10643 KETTERING DRIVE SUITE 108
CHARLOTTE NC
28226
US

V. Phone/Fax

Practice location:
  • Phone: 704-284-9570
  • Fax: 980-470-6780
Mailing address:
  • Phone: 704-284-9570
  • Fax: 980-470-6780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: