Active NPI
Clearfork Academy
- Adolescent and Children Mental Health Clinic/Center
- Fort Worth, TX
National Provider Identifier
1487215737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent and Children Mental Health Clinic/Center
- Legal business name
- CLEARFORK ACADEMY
- Practice address
- 4255 Bryant Irvin Rd
Fort Worth, TX 76109-4233 - Phone
- (817) 714-1311
- NPI assigned
- Jun 27, 2019
- Last updated
- Jun 27, 2019
- Organization subpart
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Austin Davis, LPC-SUPERVISOR
- Title
- Founder & Ceo
- Phone
- (817) 714-1311
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | Primary |
Addresses
Primary practice location
4255 Bryant Irvin Rd
Fort Worth, TX 76109-4233
Mailing address
7820 Hanger Cut Off Rd
Fort Worth, TX 76135
Phone (817) 714-1311
Other names 1
- Clearfork Academy
National Provider Directory
National Provider Directory- Part of
- Clearfork Academy
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Counselor
- Saginaw, TX
- NPI 1184906398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1561593600000",
"number": "1487215737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7820 HANGER CUT OFF RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76135",
"telephone_number": "817-714-1311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4255 BRYANT IRVIN RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761094233",
"telephone_number": "817-714-1311"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLEARFORK ACADEMY",
"organizational_subpart": "YES",
"enumeration_date": "2019-06-27",
"last_updated": "2019-06-27",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "AUSTIN",
"authorized_official_title_or_position": "FOUNDER & CEO",
"authorized_official_telephone_number": "817-714-1311",
"authorized_official_credential": "LPC-SUPERVISOR"
},
"taxonomies": [
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Clearfork Academy",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.