DEANDRIEA BASS-CARRIGAN (NPI# 1104442565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104442565 |
| Entity Type | Individual |
| Full Name | DEANDRIEA BASS-CARRIGAN |
| Credential | PH.D. |
| Practice Address |
1570 Rachel Dr Conway AR 72032-8619 |
| Practice Telephone | 5012691163 |
| Mailing Telephone | 5012691163 |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2020-06-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | A2006081 | AR | Behavioral Health & Social Service Providers |
| Street Address |
1570 RACHEL DR |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-8619 |
| 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 | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1609244151 | Matthew Spicer | Counselor | 1051 Hogan Ln, Conway, AR 72034-9126 | 2015-09-14 |
| 1578968988 | Pshanda Chante Pugh | Counselor | 1208 Dunraven Ct, Conway, SC 29527-3170 | 2014-10-28 |
| 1013294560 | Susan Ann Mclean | Counselor | 172 Waccamaw Medical Park Ct, Conway, SC 29526-8965 | 2011-11-11 |
| 1730474560 | Pamela Hendrixson | Counselor | 2159 Prince St, Suite B, Conway, AR 72034-3737 | 2011-06-09 |
| 1174832174 | Latoya Bernice Gathers | Counselor | 1632 9th Ave, Conway, SC 29527-4848 | 2010-09-25 |
| 1700023876 | Scarlett Evert | Counselor | 575 Harkrider St, Conway, AR 72032-5631 | 2009-01-12 |
| 1275722555 | Shavonne Renee Richardson | Counselor | 900c Main St, Suite B, Conway, SC 29526-4025 | 2007-10-23 |
| 1972795458 | Jessica E Goodwin | Counselor | 164 Waccamaw Medical Park, Conway, SC 29526-8903 | 2007-08-17 |
| 1609085919 | Jonathan Michael Glass | Counselor | 204 University Blvd, Conway, SC 29526-8834 | 2007-05-22 |
| Find all providers in CONWAY | ||||
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| 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.