Justin Clark Ford, MA LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

80556 Issued in TX

Practice address

3419 S Coulter St Ste 6a
Amarillo, TX 79109-3998

Phone

(806) 356-9047

Fax

(806) 356-9046

NPI assigned

Apr 30, 2020

Last updated

Apr 1, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 18, 2024 through Apr 18, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Elements Counseling and Consulting PLLC

  • Professional Counselor
  • Amarillo, TX
  • NPI 1013711159
  NPD Authorized official
• Jennings Counseling Services

  • Professional Counselor
  • Amarillo, TX
  • NPI 1770912073
  NPD (past)

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1528689569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 S COULTER ST STE 6A",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791093998",
            "telephone_number": "806-680-9371",
            "fax_number": "668-286-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 S COULTER ST STE 6A",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791093998",
            "telephone_number": "806-356-9047",
            "fax_number": "806-356-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JUSTIN",
        "middle_name": "CLARK",
        "credential": "MA LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-30",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "80556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Fong, M.D.
• John William Forage, MD
• Misty Forbes, COTA
• Christina Elaine Ford, LPC
• Christy Nicole Ford, PTA
• Kathy Ann Ford, FNP-C
• Marlene Ford
• Nancy June Ford, M.ED., LPC, LLD
• Ronald Wayne Ford, MD
• Forefront-Rush Medical Service PA

• Professional Counselor in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.