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EMILY J. CLARK LCSW LCDC
NPI 1114431624
Social Worker - Clinical in Fort Worth, TX

Active since November 20, 2017PECOS Enrolled
92.18/100
CMS Quality Rating
855 MONTGOMERY ST, FORT WORTH, TX 76107(817) 735-0510 Get Directions Write a Review

NPPES record last updated: January 18, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 18, 2019, Nov 20, 2017 (2 updates tracked since 2017).

About Emily J. Clark Lcsw Lcdc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMILY J. CLARK LCSW LCDC (NPI 1114431624) is an individual clinical provider in Fort Worth, Texas, licensed in Texas (59823) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114431624
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameEMILY J. CLARKCredential: LCSW LCDC
Location Address855 MONTGOMERY STFort Worth, TX 76107-2553
Mailing Address855 Montgomery StFort Worth, TX 76107-2553 · (817) 735-0510
Phone(817) 735-0510
Sole ProprietorNo
Enumeration DateNovember 20, 2017
Last NPPES UpdateJanuary 18, 20192 updates tracked since enumeration
✔ NPI 1114431624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in TX · 59823
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 12979 (TX)
855 MONTGOMERY ST, Fort Worth, TX 76107
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emily J. Clark Lcsw Lcdc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Emily Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Deer Oaks Geriatric Services P C
235 mi
Clinical
7272 WURZBACH RD, SUITE 706
San Antonio, TX 78240
  • Reassigned Medicare billing, Texas enrollment
  • 296 clinicians in this Medicare group
NPI 1134169287 (210) 615-3405

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
1,084 services106 patients
Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
136 services61 patients
Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
65 services51 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
53 services52 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.47 – $171.07
Typical copayment $0.00 (range $14.11 – $42.76)
Most-billed visit code NA
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.18/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.04
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER OF FORT WORTH
Pathology (Clinical Pathology/Laboratory Medicine)
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 735-2000
UNIVERSITY OF NORTH TEXAS HEALTH SCIENCE CENTER AT FORT WORTH
Family Medicine
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 735-2000
DR. MICHAEL DAVID CARLETTI D.O.
Dermatology
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 735-0278
PREMA MANJUNATH MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 927-3638
JOSE RAMON SILVAS MD
Psychiatry & Neurology (Psychiatry)
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 927-3638
KENDI HENSEL DO
Neuromusculoskeletal Medicine & OMM
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 735-2235
CHRIS CHIU
Student in an Organized Health Care Education/Training Program
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 735-2228
CHRYSTYNA KAULBACH SENKEL PA
Physician Assistant
855 MONTGOMERY ST
FORT WORTH, TX 76107
Tarrant County (817) 735-2122

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emily Clark's NPI number?

The NPI number for Emily Clark is 1114431624. It was assigned to this individual provider in the NPPES registry on November 20, 2017.

Where is Emily Clark located?

Emily Clark practices at 855 Montgomery St, Fort Worth, TX 76107. The listed phone number is (817) 735-0510.

What is Emily Clark's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Emily Clark enrolled in Medicare?

Yes. Emily Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Emily Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emily Clark reassigns Medicare benefits to Deer Oaks Geriatric Services P C (San Antonio, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Emily Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Emily Clark accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 5 other insurers list Emily Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Emily Clark was last updated on January 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.