Individual provider Active NPI

Arthur H Smith-Vaughan

  • Psychologist
  • Willow Park, TX
National Provider Identifier
1780296194
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
38545 Issued in TX
Practice address
4971 E Interstate 20 Service Rd N
Clear Fork Psychology
Willow Park, TX 76087-3220
Phone
(682) 800-4555
NPI assigned
Aug 18, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 38545 TX
Psychologist 103T00000X 38545 TX Primary

Addresses

Primary practice location

4971 E Interstate 20 Service Rd N
Clear Fork Psychology
Willow Park, TX 76087-3220

Mailing address

4971 E Interstate 20 Service Rd N Ste 100
Willow Park, TX 76087-3206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210208002328 TX Practitioner - Clinical Psychologist 1254746050 Practice locations: Willow Park, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4971 E Interstate 20 Service Rd N
Clear Fork Psychology
Willow Park, TX 76087-3220
Phone (682) 800-4555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38545TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1780296194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4971 E INTERSTATE 20 SERVICE RD N STE 100",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760873206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4971 E INTERSTATE 20 SERVICE RD N",
            "address_2": "CLEAR FORK PSYCHOLOGY",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760873220",
            "telephone_number": "682-800-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-VAUGHAN",
        "first_name": "ARTHUR",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38545",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "38545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Park, TX

Sources for this page

Verify at the official NPI Registry.