SOUTHEAST ARKANSAS BEHAVIORAL HEALTHCARE SYSTEM (NPI# 1235384009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235384009 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ARKANSAS BEHAVIORAL HEALTHCARE SYSTEM |
| Practice Address |
612 E Arkansas St Star City AR 71667-4842 |
| Mailing Address |
2500 Rike Dr Pine Bluff AR 71603-3937 |
| Practice Telephone | 8706284181 |
| Practice Fax Number | 8706285369 |
| Mailing Telephone | 8705341834 |
| Mailing Fax Number | 8705345798 |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2009-01-06 |
| Authorized Official Name | CLARENCE PERKINS (PRESIDENT, CEO) |
| Authorized Official Telephone | 8705341834 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 137459726 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386259083 | Southeast Arkansas Behavioral Healthcare System | Community/Behavioral Health | 402 N. Main Street, Suite 2, Rison, AR 71665 | 2020-09-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTHEAST ARKANSAS BEHAVIORAL HEALTHCARE SYSTEM, INC. | 2500 Rike Dr, Pine Bluff, AR 71603-3937 |
| Street Address |
612 E ARKANSAS ST |
| City | STAR CITY |
| State | AR |
| Zip Code | 71667-4842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326066853 | Cynthia G Slaughter | Social Worker | 612 E Arkansas St, Star City, AR 71667-4842 | 2006-07-17 |
| 1144792755 | Yolanda Williams | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2018-12-20 |
| 1679064828 | Brittany L Wilkins | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2018-05-23 |
| 1154830750 | Larry White | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2017-09-26 |
| 1437679172 | Alexander Black | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2017-06-23 |
| 1194174458 | Kimberly Johnson | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2016-06-08 |
| 1487011375 | Sharon Patterson | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2016-01-22 |
| 1912371550 | Candace Thomas | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2015-11-19 |
| 1477938827 | Krystal Morgan | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2015-07-28 |
| 1740661842 | Dammiccah Alsup | Counselor | 612 E Arkansas St, Star City, AR 71667-4842 | 2015-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316557143 | Christie Abella | Specialist/Technologist | 2006 Goodfellow Road, Star City, AR 71667 | 2020-08-06 |
| 1982193975 | Monticello Medical Clinic, Plc | Family Medicine | 1306 N. Lincoln Avenue, Star City, AR 71667 | 2018-05-04 |
| 1316443807 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 1306 North Lincoln Avenue, Star City, AR 71667 | 2018-04-03 |
| 1609379346 | Mainline Health Systems, Inc. | Clinic/Center | 310 Ashley St., Star City, AR 71667 | 2018-03-08 |
| 1124565213 | Mainline Health Systems, Inc | Clinic/Center | 310 Ashley St, Star City, AR 71667 | 2017-01-26 |
| 1801105424 | Tammy Renee White | Pharmacist | 1309 North Lincoln Ave, Star City, AR 71667 | 2010-09-30 |
| 1356598783 | Patrick Keith Numan | Counselor | 301 N. Oak St, Star City, AR 71667 | 2008-08-27 |
| 1568669844 | Jeri Lou Farabough | Speech-Language Pathologist | Bradley Street, Star City, AR 71667 | 2007-06-29 |
| 1396768636 | Barbara Diane Weaver | Social Worker | 110 N Drew, Star City, AR 71667 | 2006-07-26 |
| 1336184431 | University of Arkansas for Medical Sciences | Family Medicine | 203 S Jefferson St, Star City, AR 71667 | 2006-06-20 |
| Find all providers in zip 71667 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903884 | Conway County Community Service Inc. | Community/Behavioral Health | 616 E. Emma Avenue, Suite 244, Springdale, AR 72764 | 2020-08-20 |
| 1003437740 | Centers for Youth and Families, Inc. | Community/Behavioral Health | 1521 Merrill Drive, Suite D220 and E200, Little Rock, AR 72211 | 2020-05-05 |
| 1275175275 | Willow Springs Counseling | Community/Behavioral Health | 204 N Front St Ste A, Dardanelle, AR 72834-3843 | 2019-10-10 |
| 1023663630 | Arkansas Support Network, Inc | Community/Behavioral Health | 6836 Issacs Orchard Rd, Springdale, AR 72762-6096 | 2019-08-09 |
| 1972163434 | Baby Byrd, Pllc | Community/Behavioral Health | 10515 W Markham St Ste I2, Little Rock, AR 72205-2283 | 2019-06-17 |
| 1346808474 | Amy Burns, Lpc, Inc | Community/Behavioral Health | 101 W Main St Ste 200, El Dorado, AR 71730-5654 | 2019-06-04 |
| 1255994158 | Conway County Community Service Inc. | Community/Behavioral Health | 200 S Peabody Ave, Mountain View, AR 72560-6311 | 2019-04-16 |
| 1134685225 | Northeast Arkansas Community Mental Health Center Inc | Community/Behavioral Health | 807 W Main St Ste A&b, Trumann, AR 72472-2611 | 2019-02-14 |
| 1891263091 | Northeast Arkansas Community Mental Health Center Inc | Community/Behavioral Health | 623 N 9th St Ste 200, Augusta, AR 72006-2103 | 2018-11-06 |
| 1821564436 | Bokker Enterprises, Inc. | Community/Behavioral Health | 115 Turner Lane, Ste #2, Salem, AR 72576 | 2018-10-22 |
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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.