Active NPI
Deborah Jean Clark, LMSW,LMFT
- Marriage & Family Therapist
- Dallas, TX
National Provider Identifier
1811056013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 06855
- Practice address
- 6301 Gaston Ave
Ste 620
Dallas, TX 75214-3922 - Phone
- (214) 370-5333
- Fax
- (214) 370-5331
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 06855 | TX | |
| Marriage & Family Therapist | 106H00000X | 06855 | TX | Primary |
Addresses
Primary practice location
6301 Gaston Ave
Ste 620
Dallas, TX 75214-3922
Mailing address
6301 Gaston Ave
Ste 620
Dallas, TX 75214-3922
Phone (214) 370-5333
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00P79P | Other | TX | BCBS |
| 0969135 | Other | TX | AETNA |
| 127007 | Other | TX | VALUE OPTIONS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06855 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1811056013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6301 GASTON AVE",
"address_2": "STE 620",
"city": "DALLAS",
"state": "TX",
"postal_code": "752143922",
"telephone_number": "214-370-5333",
"fax_number": "214-370-5331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6301 GASTON AVE",
"address_2": "STE 620",
"city": "DALLAS",
"state": "TX",
"postal_code": "752143922",
"telephone_number": "214-370-5333",
"fax_number": "214-370-5331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DEBORAH",
"middle_name": "JEAN",
"credential": "LMSW,LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "06855",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "06855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00P79P",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0969135",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "127007",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, 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.