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Organization

CANVAS OUTPATIENT, PLLC

Active
Other names
Canvas Outpatient, PLLC, Canvas Outpatient
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ASHLEY STAFFORD LCSW-S (OWNER/DIRECTOR)
(214) 674-0798
Entity
Organization

Contact information

Practice address
5521 BELLAIRE DR S STE 114, FORT WORTH, TX 76109-5855
(817) 394-2346
(817) 520-8520
Mailing address
5521 BELLAIRE DR S STE 114, FORT WORTH, TX 76109-5855
(817) 394-2346
(817) 520-8520

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
08/07/2023
Last updated
02/03/2026
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