STACIE MICHELLE CORNWELL


Address: 1306 Military Rd Ste 1, Benton, AR 72015-2732
Phone: 5014818930

STACIE MICHELLE CORNWELL (NPI# 1255868774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255868774
Entity Type Individual
Full Name STACIE MICHELLE CORNWELL
Credential MSED
Practice Address 1306 Military Rd Ste 1
Benton
AR 72015-2732
Mailing Address 2915 Saint Andrews Dr
Benton
AR 72019-6874
Practice Telephone 5014818930
Practice Fax Number 5014084699
Mailing Telephone 5014818930
Mailing Fax Number 5014084699
Enumeration Date 2017-05-15
Last Update Date 2017-05-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 222Q00000X Developmental Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 1306 MILITARY RD STE 1
City BENTON
State AR
Zip Code 72015-2732

Providers in the same location

NPI Name Taxonomy Address Enumeration
1003341900 Taralee Reeves Occupational Therapist 1306 Military Rd Ste 1, Benton, AR 72015-2732 2017-04-28
1922508613 Elizabeth Clark Physical Therapist 1306 Military Rd Ste 1, Benton, AR 72015-2732 2018-02-19
1760997498 Jessica Lee Forthman Specialist/Technologist 1306 Military Rd Ste 1, Benton, AR 72015-2732 2017-12-04
1568986248 Arkansas Therapy Outreach, LLC Clinic/Center 1306 Military Rd Ste 1, Benton, AR 72015-2732 2017-08-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790343135 Justin King Case Manager/Care Coordinator 1502 Mary Kay Blv6, Benton, AR 72015 2019-05-31
1790253326 Seth Alexander Weisheit Nurse Practitioner 824 Military Road, Benton, AR 72015 2018-11-13
1396269627 Abby G Sims Speech-Language Pathologist 3391 Peachtree Lane, Benton, AR 72015 2017-07-28
1225551278 Jessica R Poe Case Manager/Care Coordinator 1502 Marykay Blvd, Benton, AR 72015 2017-07-21
1003357997 Jamaal Langston Case Manager/Care Coordinator 1502 Mark Kay Blvd, Benton, AR 72015 2017-03-13
1881138550 Shannon Gachot-ridgley Counselor 205 South Street Suite 3, Benton, AR 72015 2016-12-14
1295104578 Excel Health of Haskell, Pllc Clinical Nurse Specialist 6029 Us Hwy 67, Haskell, AR 72015 2015-09-17
1528464054 Kacey Jo Kiker Nurse Practitioner 620 W South St, Benton, AR 72015 2014-11-11
1700218252 Jamie Brunt Licensed Practical Nurse 1718 Old Hot Springs Rd, Benton, AR 72015 2013-08-07
1760738942 Kari J Richards Physical Therapist 5701 Springhill Rd, Bryant, AR 72015 2012-07-25
Find all providers in zip 72015

Taxonomy Information

Taxonomy Code 222Q00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Developmental Therapist

Taxonomy Definition

A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development.
Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154680437 Jillian Renee Carpenter Developmental Therapist 401 W 6th St, Benton, IL 62812-1247 2012-05-08
1164656583 Patricia A. Slater Developmental Therapist 221 Benton Neck Rd., Benton, ME 04901 2009-05-13
1922456102 Elissa Locker Developmental Therapist 114 Greenwood Pl, Benton, KY 42025-7640 2016-05-29
1174978936 Misty Lawson Developmental Therapist 114 Greenwood Pl, Benton, KY 42025-7640 2016-04-29
1205211844 Sharon Powell Developmental Therapist 610 Hwy 5 N, Benton, AR 72019-8559 2015-07-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1396379897 Allison Nicole Davis Developmental Therapist 104 Hope St, Hoxie, AR 72433-9014 2020-02-24
1174161707 Anna Shrum Developmental Therapist 721 Alford Street, Flippin, AR 72634 2019-12-13
1033752290 Krista Crainer Developmental Therapist 4701 N Carbon City Rd, Ozark, AR 72949 2019-10-21
1063061216 Dawn Renae Burnett Developmental Therapist 2001 E Kiehl Ave Ste 12, Sherwood, AR 72120-3123 2019-09-10
1972165827 Heather Marie Box Developmental Therapist 344 Fayetteville Ave, Alma, AR 72921-3655 2019-07-01
1861954950 Darnise Lashelle Price Developmental Therapist 18 Woodbriar Dr, Jacksonville, AR 72076-5365 2019-04-05
1164984373 Keys (keeping Every Youth Safe) Developmental Therapist 2717 So Ringo Street, Little Rock, AR 72206-6554 2019-04-05
1194215350 Amy Carol Yetley Developmental Therapist 8 Van Lee Dr, Little Rock, AR 72205-2452 2018-05-14
1447759782 Lashauna Walton Developmental Therapist 129 Harvick Cir, Cabot, AR 72023-7107 2018-02-01
1780102210 Janet Karen Watkins Developmental Therapist 1810 Ozarka College Drive, Mountain View, AR 72560 2017-09-05
Find all providers with the same taxonomy

Competitor

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City BENTON
Zip Code 72015

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Dataset Information

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.

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