How many therapy group practices does Texas have?

No public source counts Texas therapy group practices, and a count of them has to be built. The nearest measured figure is 13,659 active organization NPIs in Texas with a behavioral-health primary taxonomy, in the federal NPI registry file dated September 14, 2026. That's a count of registrations, not of practices, and this guide shows why it overstates them.

We computed every figure below from public federal files, and the methods and limits come after the numbers. The Texas figures are NPIs and Medicare-enrolled clinicians. The one count by size covers the 11-county Dallas-Fort Worth metro and we did not extend it to the rest of Texas. It covers organizations that hold an organization NPI, so it misses a group that bills only under its clinicians' own NPIs. It sorts organizations by name and taxonomy rules, so a practice near a boundary can land on the wrong side.

How many behavioral-health organizations does Texas have in the federal NPI registry?

Texas has 13,659 active organization NPIs whose primary taxonomy is a behavioral-health one, and 16,051 if a behavioral-health taxonomy in any of the 15 taxonomy slots counts. We counted them in the National Plan and Provider Enumeration System (NPPES) full file dated September 14, 2026, which CMS publishes monthly. An organization NPI is entity type 2. The geography is the state in the record's practice location address.

The first five families are the clinician types and hold 9,729 of the 13,659. The last four are facility types and hold 3,930. Under "any slot" the families add to more than the total, because one NPI can list several taxonomies. The codes come from the NUCC Health Care Provider Taxonomy code set, and the code descriptions are theirs. Our method matched each code by its prefix, so a code such as 101Y includes every subspecialty under it.

Source: our computation on the NPPES file dated September 14, 2026.

Why is the registry count not a count of Texas therapy group practices?

The registry count is not a count of practices because it counts NPIs, and one practice can hold several NPIs while a clinician's own company holds one. The federal rule that creates the extra NPIs is 45 CFR §162.410(a)(1), which we read in the eCFR on October 19, 2026.

Obtain, by application if necessary, an NPI from the National Provider System (NPS) for itself or for any subpart of the covered entity that would be a covered health care provider if it were a separate legal entity.

A practice with a component that is not a separate legal entity, such as a unit that runs its own billing, can therefore hold more than one organization NPI. The registry holds no field that links them. Three more things push the count above the number of practices.

• Solo companies. A clinician who runs a one-person PLLC holds an organization NPI. The next section sizes this.
• The agency code. The 2,000 Texas NPIs whose primary taxonomy is 251S00000X are a broad category, and part of it is not mental health.
• Facilities. The clinic and agency families include hospital departments and public agencies that no therapy-group product serves.

Two things push the count below the number of practices. A practice that bills only through its clinicians' individual NPIs has no organization NPI. A group whose organization NPI lists a taxonomy outside the nine families is missed. Our data cannot size either one.

Source: our reading of the registry, with the rule from the eCFR. The direction and size of the net error are not known.

How many Texas organization NPIs look like one clinician's own company?

At most 5,529 of the 13,659 Texas organization NPIs, or 40.5%, look like a clinician's own company, and that figure is an upper bound from a name match, not a measurement. We tested every Texas organization NPI with a behavioral-health primary taxonomy. The test asked whether an individual clinician with a behavioral-health primary taxonomy had the same last name, the same first name and the same first five ZIP digits as the organization's authorized official in NPPES. No authorized official's name was blank, so the test left nothing out for that reason.

The match overstates in one way and understates in another.

• It overstates when the owner of a multi-clinician group is also its authorized official and has an individual NPI in the same ZIP. It also overstates when an unrelated clinician shares the official's name and ZIP.
• It understates when the official's individual NPI carries a different taxonomy, spelling or ZIP. The match cannot see those solo companies.

The registry records who signed for an organization and not who owns it, so the match is not an ownership test. We do not know which way the errors net out.

Source: our computation on the NPPES file dated September 14, 2026.

What range of Texas organizations does that leave?

Subtracting the solo-looking upper bound leaves a range of 4,200 to 8,130 Texas organization NPIs that do not look like one clinician's own company. This range is our estimate, not a count, and it is a range of NPIs and not of practices. It is built from two subtractions of the figures above.

The low end assumes every solo-looking NPI sits in a clinician-type family and drops the facility families entirely. The high end keeps all nine families, which keeps facilities that are not therapy groups. The registry carries no ownership type, size or revenue field, so we could not separate the two. The range is not a floor. Subparts would pull the true practice count under both ends, and solo companies the name match missed would sit inside the remainder.

Source: our arithmetic on the two counts above.

How many Texas therapists work in a group, and how big is it?

Of 8,731 Medicare-enrolled Texas clinicians in four specialties, 51.3% are in some organization and 13.8% are in one with 6 to 30 members. These are shares of clinicians, not counts of practices. We computed them from the CMS Doctors and Clinicians national downloadable file released September 10, 2026. The four specialties are clinical psychologist, clinical social worker, marriage and family therapist and mental health counselor.

The US column covers 163,303 clinicians in the same four specialties. Each clinician is counted once. Their organization size is the largest member count among their Medicare rows in that geography, and a clinician is in Texas if any of their rows has the state TX. The file lists no clinician in an organization of exactly one member. Of the 4,480 Texas clinicians in an organization, 59.1% are in one with more than 30 members. Texas therapists in this file are less often in any organization than the US figure for three of the four specialties, and those who are in one lean toward larger ones.

The numbers leave out every clinician who is not enrolled in Medicare, such as those who take only cash or commercial insurance. We think these clinicians are more often solo, but we did not measure it, so the true group share among all Texas therapists is probably lower than 51.3%. An organization in this file can also be a hospital, a school-based program or a multispecialty medical group. We did not confirm from CMS's data dictionary what the member count includes.

Source: our computation on the CMS Doctors and Clinicians file released September 10, 2026.

How many Dallas-Fort Worth organizations look like therapy group practices, by size?

Of 3,708 organizations we built from the 11-county Dallas-Fort Worth metro's organization NPIs, 132 independent practices have an estimated 6 to 30 licensed clinicians and 248 have 3 to 5. The other 3,328 include 2,537 with 0 to 2 clinicians and 144 institutions or facilities, so the total is not a count of group practices. We built the list on October 13, 2026 from the same NPPES file plus three other public files, described in the next sections. The counties are Collin, Dallas, Denton, Ellis, Hunt, Johnson, Kaufman, Parker, Rockwall, Tarrant and Wise.

Of the 132 practices in the 6 to 30 band, 106 are high confidence and 26 are medium. High confidence means three or more clinicians share the practice's own phone number, or Medicare lists three or more in the group. Medium means the estimate rests on a shared suite address alone.

Every clinician figure is a floor. The estimate for each practice is the larger of two counts: the clinicians the registry ties to the practice's phone or full address, and the Medicare clinicians listed in a group with the same name. A clinician the registry does not tie to the practice, and Medicare does not list in it, is not counted. A clinician who lists a home address or a personal phone is not counted. The 4,823 organization NPIs in the metro with a behavioral-health taxonomy in any slot were joined into the 3,708 organizations.

Separately, 56 phone numbers are each listed by 6 or more metro clinicians and belong to no organization on our metro list, 683 clinicians in all. Some may be groups that bill under each clinician's own NPI, and some may be billing or answering services. We treat them as leads and not as practices, and they are not in the table, so the table misses any group of this kind.

Source: our computation of October 13, 2026 on the NPPES file dated September 14, 2026 and the other files listed below.

Which data did the counts use, and from which dates?

The counts use four public federal files in the releases below. The row counts are as reported when we ran the counts, and we did not download the files again to verify them for this guide.

CMS has since posted newer files. Its NPPES page now lists a full file dated October 12, 2026, and the Doctors and Clinicians page now shows a release of October 15, 2026 with the next update due November 12, 2026. We have not rerun the counts on them, so the figures above describe the September files. CMS replaces the NPPES monthly file, so a link to the page will not serve the file we used.

The NPPES run read all 9,798,758 rows once, as reported in its run log. It read only entity type 1 (individual) and entity type 2 (organization) rows. The 355,329 rows with no entity type all carried an NPI deactivation date, so deactivated NPIs are excluded from every count. A row counts as "primary" when the Primary Taxonomy Switch on that taxonomy slot is Y, and as "any" when the code appears in any of the 15 slots. Each NPI is counted once per family and once in the total. The Dallas-Fort Worth step assigned each ZIP to the county that holds most of its land, so a ZIP that straddles the metro's edge falls on one side.

What counts as a group practice here, and what did we leave out?

For the Dallas-Fort Worth count, a group practice is an independent outpatient therapy practice made of one or more organization NPIs joined by a shared name or phone, sized by its estimated licensed clinicians. The statewide figures above use no such definition, because the registry cannot give one.

We joined organization NPIs into one practice when they share a normalized legal or trade name, or share a practice phone that at most three organization NPIs use. A phone shared more widely is treated as a billing service and joins nothing. A clinician is one individual NPI with a behavioral-health primary taxonomy and a metro practice address. We credit a clinician to a practice when their practice phone equals the practice's, or their full practice address, suite included, equals the practice's. A phone or suite that two or more practices list attaches no clinician, because a shared therapy suite is no evidence that the people in it work together. The clinician estimate is the larger of that registry count and the number of Medicare clinicians in a group with the same normalized name, so a practice's figure can come from Medicare alone.

We set a practice aside, in this order, when it is:

1. An institution or facility. Its name matches a hospital, health system, university, school district, county, public mental health authority, residential, detox or treatment center, or home health agency. Its only taxonomy is substance use rehabilitation. It is one of two names we read by hand.
2. An intensive outpatient or partial hospitalization program.
3. A nonprofit. Its legal name is in the IRS Texas exempt-organization file, or carries a nonprofit word without a for-profit form such as PLLC, LLC, PA or PC.
4. Headquartered outside Texas. Every NPI's mailing address is in another state.
5. A community agency. Its primary taxonomy is 251S only. Agencies with 6 or more clinicians are not dropped but listed for review, because some therapy groups register this way.

Facilities, programs, nonprofits and out-of-state chains buy differently from an independent group, which is why they are apart. These are name and taxonomy rules, so a practice near a boundary can land on the wrong side.

What can these counts not tell a Texas practice owner?

These counts cannot tell an owner how many Texas practices exist, which ones are insured or self-pay, how many clinicians any practice has, or who owns it. Each limit comes from the data.

• Texas has no count of practices. The statewide figures are NPIs and Medicare-enrolled clinicians. We did not run the practice-joining step outside Dallas-Fort Worth, and we do not extrapolate from it.
• The registry records what providers reported. 45 CFR §162.410(a)(4) asks a covered provider to report changes to its required data within 30 days. A record can still list a clinician who has stopped practicing, and we could not size that.
• Every clinician count is a floor. The Dallas-Fort Worth count credits only clinicians the registry ties to a practice. The Medicare count covers only clinicians enrolled in Medicare.
• Ownership is not in the registry. The authorized official is who the practice named to CMS and not necessarily the owner. Two practices with one owner and different names stay two practices.
• Telehealth-only practices may list a state other than the one they serve, and practices outside the 11 counties that serve Dallas-Fort Worth by telehealth are not in the metro count.
• The files are a month or more old. A practice that opened, closed or merged after September 2026 is not reflected.

What to do this week

An owner can size their own local market with the same public data in seven steps. A spreadsheet works for a single county, and a script is faster for a metro.

1. Download the NPPES full file and write down its date and row count. For a handful of lookups, the NPI Registry search needs no download.
2. Decide the area as a list of counties. Use the Census ZCTA to county file to turn each county into its ZIP codes.
3. Keep entity type 2 rows with a practice address in those ZIP codes and a behavioral-health taxonomy. Write down the taxonomy codes you chose from the NUCC code set, and whether you matched the primary taxonomy or any slot.
4. Join rows into practices by shared name or phone, and decide the rule for a phone used by many organizations before you count.
5. Count clinicians: entity type 1 rows with a behavioral-health taxonomy whose practice phone or full address with suite matches the practice's. Skip a phone or suite that several practices share.
6. Set aside hospitals, programs and nonprofits, and check names against the IRS exempt organizations file. Record how many you set aside for each reason.
7. Report the result as a floor with the file dates, the definition you used and the number set aside, the way the Dallas-Fort Worth table above does.

Where Practice Pillar fits

Practice Pillar is software for therapy group practices. Its operations page lists manuals, scorecards, onboarding, licenses, training and automations for the people who run a practice. No count in this guide comes from Practice Pillar's product or from any customer.

Sources

• CMS NPPES NPI files page, Centers for Medicare & Medicaid Services. The page now shows only the October 2026 full file, dated October 12, 2026. The counts use the September 14, 2026 file, which we did not rerun on the newer one. Page checked October 19, 2026.
• Doctors and Clinicians national downloadable file, dataset mj5m-pzi6, CMS. Shows modified October 2, 2026, released October 15, 2026 and next update November 12, 2026. The counts use the September 10, 2026 release and were not rerun on the newer one. Page checked October 19, 2026.
• 45 CFR §162.410, Implementation specifications: Health care providers, Electronic Code of Federal Regulations, text as of October 15, 2026. Checked October 19, 2026.
• Health Care Provider Taxonomy code set, National Uniform Claim Committee. Version 26.1, effective July 1, 2026. Checked October 19, 2026.
• 2020 relationship files, ZCTA to county, US Census Bureau. Checked October 19, 2026.
• Exempt Organizations Business Master File Extract, Internal Revenue Service. Data posted October 13, 2026. Checked October 19, 2026.