Individual
DR. CARY LEONARD CLARK SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6461 SOUTHWEST BLVD, FT WORTH, TX 76132
(817) 782-1006
(817) 737-7484
Mailing address
6461 SOUTHWEST BLVD, FT WORTH, TX 76132
(817) 782-1006
(817) 737-7484
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
8755
TX
106H00000X
Marriage & Family Therapist
Primary
1321
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
453710001208
—
TX
Enumeration date
08/23/2006
Last updated
09/11/2025
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