DR. PORNTHIP CHALUNGSOOTH (NPI# 1104911510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104911510 |
| Entity Type | Individual |
| Full Name | DR. PORNTHIP CHALUNGSOOTH |
| Credential | L.P.C. |
| Practice Address |
525 N. Garland Ave. Fayetteville AR 72701 |
| Mailing Address |
1005 E. Rolling Hills Dr. Fayetteville AR 72703 |
| Practice Telephone | 4795755276 |
| Practice Fax Number | 4795757438 |
| Mailing Telephone | 4795821245 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | P9307012 | AR | Behavioral Health & Social Service Providers |
| Street Address |
525 N. GARLAND AVE. |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588213417 | Biggers Counseling, LLC | Social Worker | 349 S Hill Ave, Fayetteville, AR 72701 | 2019-09-04 |
| 1235603200 | Arkansas Holistic Health Care Chiropractic | Chiropractor | 2618 Mlk Jr Blvd, Fayetteville, AR 72701 | 2019-01-14 |
| 1225520828 | Jacoby Markie Clemons | Specialist/Technologist | 1201 West Leroy Pond Dr, Fayetteville, AR 72701 | 2018-05-31 |
| 1952892390 | Ambur Dryer | Specialist/Technologist | 994 W Mlk Jr. Blvd., Fayetteville, AR 72701 | 2018-05-22 |
| 1851814230 | Blakely Low | Psychologist | 1229 Meadow Street Suite #221, Jones Family Center for Student-athlete Success, Fayetteville, AR 72701 | 2017-07-18 |
| 1518496215 | Van Michael Mcqueen Jr. | Dentist | 640 N Garland Ave # 104, Fayetteville, AR 72701 | 2017-06-06 |
| 1407204217 | Kenna Megan Hodeaux | Specialist/Technologist | 1201 Leroy Pond Drive, Sports Medicine Department, Fayetteville, AR 72701 | 2016-06-02 |
| 1740634435 | Crystal Susan Rofkahr | Psychologist | 26 E Meadow St Ste 3, Fayetteville, AR 72701 | 2016-04-19 |
| 1942663521 | Satoshi IIda | Specialist/Technologist | 1010 S Dunn Ave., Apt 205a, Fayetteville, AR 72701 | 2016-04-01 |
| 1992163901 | Dr Don M Chaney Dds Pa | Dentist | 1826 N. Crossover Road, Suite 2, Fayetteville, AR 72701 | 2016-02-04 |
| Find all providers in zip 72701 | ||||
| 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 |
|---|---|---|---|---|
| 1619576352 | Bianca Faith Monroe | Counselor | 111 Lamon St Ste 100, Fayetteville, NC 28301-4917 | 2020-10-23 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1760032239 | Peyton Elaine Smith | Counselor | 2403 Main Dr Ste 1&2, Fayetteville, AR 72704-5223 | 2019-09-17 |
| 1467014746 | Tennille Kristine Wilson | Counselor | 6415 Camden Rd Ste 109, Fayetteville, NC 28306-7584 | 2019-07-08 |
| 1366914004 | Katie Frankum | Counselor | 6805 Woodmark Dr, Fayetteville, NC 28314-6458 | 2018-12-19 |
| 1588132534 | Sara Penney | Counselor | 351 Wagoner Dr Ste 135, Fayetteville, NC 28303-4608 | 2018-11-07 |
| 1578045589 | Tamara Smith Thom | Counselor | 2307 Cumberland Gap Dr, Fayetteville, NC 28306-6940 | 2018-09-06 |
| 1003393968 | Melissa Stone Martinez | Counselor | 175 Bradford Sq Ste D, Fayetteville, GA 30215-1967 | 2018-07-24 |
| 1629561568 | Hamlin Glover Consulting Group, LLC | Counselor | 3681 Raeburn Ct, Fayetteville, NC 28314-2623 | 2018-06-13 |
| 1861983439 | Jessica Lynne Smith | Counselor | 6885 Cliffdale Rd Ste 2002, Fayetteville, NC 28314 | 2018-05-19 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72701 |
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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.