THERAPY ASSESSMENT CENTER, LLC (NPI# 1093184210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093184210 |
| Entity Type | Organization |
| Organization Name | THERAPY ASSESSMENT CENTER, LLC |
| Practice Address |
317 Oak St Ste 3 Conway AR 72032 |
| Mailing Address |
317 Oak St Ste 3 Conway AR 72032-5679 |
| Practice Telephone | 5012913091 |
| Practice Fax Number | 5015880484 |
| Mailing Telephone | 5012913091 |
| Mailing Fax Number | 5015880484 |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2019-09-06 |
| Authorized Official Name | DR. SAMANTHA SEWELL SHORT (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 5012913091 |
| Authorized Official Credential | PSYD., LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1422 Caldwell St, Suite P, Conway, AR 720345319 | 5012913091 |
| Street Address |
317 OAK ST STE 3 |
| City | CONWAY |
| State | AR |
| Zip Code | 72032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144465139 | Samantha Sewell Short | Psychologist | 317 Oak St Ste 3, Conway, AR 72032-5679 | 2008-12-05 |
| 1962813766 | Samantha Lovell | Counselor | 317 Oak St Ste 3, Conway, AR 72032-5679 | 2014-05-14 |
| 1184041808 | Lauren Watts | Counselor | 317 Oak St Ste 3, Conway, AR 72032-5679 | 2014-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| Taxonomy Code | 103TP2701X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Group Psychotherapy |
| Definition to come... |
| Notes: [1/1/2007: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841541067 | Sara Tolleson | Psychologist | 2200 Fort Roots Drive, North Little Rock, AR 72114-6544 | 2012-09-27 |
| 1447313309 | Peggy Ann James | Psychologist | 4400 Shuffield Dr, Little Rock, AR 72205-7100 | 2006-12-19 |
Please comment or provide details below to improve the information on THERAPY ASSESSMENT CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.