DR. CARY LEONARD CLARK SR. (NPI# 1164539516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164539516 |
| Entity Type | Individual |
| Full Name | DR. CARY LEONARD CLARK SR. |
| Credential | PHD |
| Practice Address |
6461 Southwest Blvd Ft Worth TX 76132 |
| Practice Telephone | 8177821006 |
| Practice Fax Number | 8177377484 |
| Mailing Telephone | 8177821006 |
| Mailing Fax Number | 8177377484 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101Y00000X | Counselor | 8755 | TX | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 1321 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 453710001208 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477947190 | Cary Ann Clark | Counselor | 2218 Jackson Ave Nw, Olympia, WA 98502-4535 | 2015-03-19 |
| 1629077987 | Cary Byron Clark | Emergency Medicine | 10901 Bakers Crossing Rd, Bluff Dale, TX 76433-5111 | 2005-07-19 |
| Street Address |
6461 SOUTHWEST BLVD |
| City | FT WORTH |
| State | TX |
| Zip Code | 76132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669843 | Rubilene Spinks | Pharmacist | 6300 Oakmount Blvd, Fort Worth, TX 76132 | 2020-11-03 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1134781792 | Daniel Max & Marcandrea LLC | Optometrist | 4619 S Hulen St, Suite C, Fort Worth, TX 76132 | 2019-07-03 |
| 1568029320 | Ty Desilets | Physical Therapist | 5959 Bryant Irvin Rd Suite 100, Fort Worth, TX 76132 | 2019-05-28 |
| 1750844049 | Fort Worth Surgical Center Lp | Clinic/Center | 6949 Bryant Irvin Road, Fort Worth, TX 76132 | 2019-04-12 |
| 1063971232 | Symetria Health of Texas, LLC | Clinic/Center | 7299 Hawkins View Drive, Fort Worth, TX 76132 | 2019-03-18 |
| 1275015612 | Falguni Udayan Patel | Nurse Practitioner | 6100 Harris Pkwy Ste 1230, Fort Worth, TX 76132 | 2018-09-02 |
| 1881110161 | Because De Cares | Private Vehicle | 7101 Bryant Irving Road #33104, Fort Worth, TX 76132 | 2017-08-17 |
| 1871045708 | Cns - F.w., LLC | Clinic/Center | 6940 Harris Parkway, Fort Worth, TX 76132 | 2016-10-26 |
| 1790233294 | Prime Diagnostic Imaging of Fort Worth, LLC | Clinic/Center | 6491 Southwest Blvd., Benbrook, TX 76132 | 2016-09-14 |
| Find all providers in zip 76132 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| 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. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740890946 | Alvin Snorton | Counselor | 601 University Dr Ste 112, Ft Worth, TX 76107-2170 | 2020-08-03 |
| 1174035455 | Bright Morning Star Ministries | Counselor | 707 North Fwy Ste 111, Ft Worth, TX 76102-1702 | 2017-10-26 |
| 1710247135 | Laurie Ann Walker | Counselor | 3309 Winthrop Ave Ste 90, Ft Worth, TX 76116-5600 | 2012-05-18 |
| 1699007575 | Ladonna Tennille Covington | Counselor | 100 E. 15th Street, Suite 340, Ft Worth, TX 76102 | 2010-02-03 |
| 1861521494 | Jim Byron Roaten | Counselor | 5608 Malvey Ave Ste 101, Ft Worth, TX 76107-5107 | 2007-03-02 |
| 1770633935 | Barbara G Howard | Counselor | 2707 Airport Fwy Ste 212, Ft Worth, TX 76111-2370 | 2007-01-11 |
| 1790835064 | Melanie E Hansen | Counselor | 1002 Montgomery St Ste 200, Ft Worth, TX 76107-2693 | 2007-01-11 |
| 1821634445 | Brenda A Marsden | Counselor | 4801 Brentwood Stair Rd Ste 404, Ft Worth, TX 76103-1731 | 2019-11-19 |
| 1184181562 | Lanaya L Wood | Counselor | 3309 Winthrop Ave Ste 90, Ft Worth, TX 76116-5600 | 2019-02-21 |
| 1568943983 | Robert Townley | Counselor | 4500 Mercantile Plaza Dr Ste 307, Ft Worth, TX 76137-4230 | 2018-08-23 |
| Find all providers in FT WORTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.