Crystal Clark, PHD

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

79203 Issued in TX

Practice address

306 N Loop 288 Ste 123
Denton, TX 76209-4218

Phone

(469) 626-7511

Fax

(469) 613-0883

NPI assigned

May 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• A Family Place - Counseling, PLLC

  • Multi-Specialty Clinic/Center
  • Plano, TX
  • NPI 1205969714
  NPD

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1619614195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N LOOP 288 STE 123",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762094218",
            "telephone_number": "469-626-7511",
            "fax_number": "469-613-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N LOOP 288 STE 123",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762094218",
            "telephone_number": "469-626-7511",
            "fax_number": "469-613-0883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 E Park Blvd Ste 280",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750748862",
            "country_code": "US",
            "telephone_number": "469-626-7511",
            "fax_number": "469-613-0883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CRYSTAL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE - LPC",
            "identifier": "79203",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• City of Denton (Denton Fire Department)
• Civitas Clinical Services LLC
• Erin Clancy
• Clara H. Henry, M.D., P.a.
• Brian Clark, PHARMD
• Daniel Lewis Clark, PTA
• Eva-Sophia Clark, MA, LCSW, LCDC, EMDR
• Kayla Ennette Clark, MS, LPC
• Natalie Lauren Clark
• Susan Zeringue Clark, OT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.