NPIMap

Organization Active NPI

Counseling and Psychotherapy Services

  • Mental Health Counselor
  • Benbrook, TX
National Provider Identifier
1003092941
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8755 Issued in TX
Legal business name
COUNSELING AND PSYCHOTHERAPY SERVICES
Practice address
6461 Southwest Blvd
Benbrook, TX 76132-2777
Phone
(817) 782-1006
NPI assigned
Jan 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Cary Leonard ClarkNPI 1164539516
Title
Owner
Phone
(817) 782-1006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 8755 TX Primary

Addresses

Primary practice location

6461 Southwest Blvd
Benbrook, TX 76132-2777

Mailing address

6461 Southwest Blvd
Fort Worth, TX 76132

National Provider Directory

National Provider Directory

Locations

6461 Southwest Blvd
Benbrook, TX 76132
Phone (817) 782-1006

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1003092941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6461 SOUTHWEST BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6461 SOUTHWEST BLVD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761322777",
            "telephone_number": "817-782-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING AND PSYCHOTHERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CARY",
        "authorized_official_middle_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-782-1006",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "8755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benbrook, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.