Active NPI
Cary Leonard Clark Sr., PHD
- Marriage & Family Therapist
- Ft Worth, TX
National Provider Identifier
1164539516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1321
- Practice address
- 6461 Southwest Blvd
Ft Worth, TX 76132 - Phone
- (817) 782-1006
- Fax
- (817) 737-7484
- NPI assigned
- Aug 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 8755 | TX | |
| Marriage & Family Therapist | 106H00000X | 1321 | TX | Primary |
Addresses
Primary practice location
6461 Southwest Blvd
Ft Worth, TX 76132
Mailing address
6461 Southwest Blvd
Ft Worth, TX 76132
Phone (817) 782-1006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 453710001208 | Medicaid | TX |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8755 | TX | MD | Counselor |
| 1321 | TX | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling and Psychotherapy Services | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Benbrook, TX
- NPI 1003092941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1164539516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6461 SOUTHWEST BLVD",
"city": "FT WORTH",
"state": "TX",
"postal_code": "76132",
"telephone_number": "817-782-1006",
"fax_number": "817-737-7484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6461 SOUTHWEST BLVD",
"city": "FT WORTH",
"state": "TX",
"postal_code": "76132",
"telephone_number": "817-782-1006",
"fax_number": "817-737-7484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CARY",
"middle_name": "LEONARD",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "8755",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "1321",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "453710001208",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ft Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.