Individual provider Active NPI

Eva-Sophia Clark, MA, LCSW, LCDC, EMDR

  • Social Worker
  • Denton, TX
National Provider Identifier
1003466947
Registry record updated Mar 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
66542 Issued in TX
Practice address
501 S Carroll Blvd Ste 203
Denton, TX 76201-7423
Phone
(682) 299-9406
NPI assigned
Sep 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 66542 TX Primary

Addresses

Primary practice location

501 S Carroll Blvd Ste 203
Denton, TX 76201-7423

Mailing address

12650 N Beach St Ste 114
Fort Worth, TX 76244-4245
Phone (682) 299-9406

Other practice location 1

501 S Carroll Blvd Ste 203
Denton, TX 76201-7423
Phone (682) 299-9406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
66542TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Better Now Counseling, PLLC CurrentSince Apr 6, 2021 Accepting new patients

Locations

501 S Carroll Blvd
Ste 203
Denton, TX 76201
Phone (682) 299-9406

12650 N Beach St
Ste 114
Fort Worth, TX 76244
Phone (682) 249-2853

Networks

  • TX HMO
  • TX HMO D-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616284800000",
    "number": "1003466947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12650 N BEACH ST STE 114",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444245",
            "telephone_number": "682-299-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S CARROLL BLVD STE 203",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762017423",
            "telephone_number": "682-299-9406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Carroll Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762017423",
            "country_code": "US",
            "telephone_number": "682-299-9406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EVA-SOPHIA",
        "name_prefix": "Ms.",
        "credential": "MA, LCSW, LCDC, EMDR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "66542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; 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.