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Individual

DEBORAH JEAN CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW,LMFT

Contact information

Practice address
6301 GASTON AVE, STE 620, DALLAS, TX 75214-3922
(214) 370-5333
(214) 370-5331
Mailing address
6301 GASTON AVE, STE 620, DALLAS, TX 75214-3922
(214) 370-5333
(214) 370-5331

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
06855
TX
106H00000X
Marriage & Family Therapist
Primary
06855
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00P79P
BCBS
TX
01
0969135
AETNA
TX
01
127007
VALUE OPTIONS
TX
Enumeration date
12/06/2006
Last updated
09/11/2025
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