MRS. LYDIA JEANNINE BURRIS (NPI# 1306027339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306027339 |
| Entity Type | Individual |
| Full Name | MRS. LYDIA JEANNINE BURRIS |
| Credential | LPC |
| Practice Address |
350 Salem Rd Ste 1 Conway AR 72034-6166 |
| Mailing Address |
2400 S 48th St Springdale AR 72762-6683 |
| Practice Telephone | 5013368300 |
| Practice Fax Number | 5013295508 |
| Mailing Telephone | 4797502020 |
| Mailing Fax Number | 4797504843 |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2020-05-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
P0802024 | AR | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
P0802024 | AR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 227121719 | 05 |
| Street Address |
350 SALEM RD STE 1 |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-6166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376518589 | Atif M Akhtar | Psychiatry & Neurology | 350 Salem Rd Ste 1, Conway, AR 72034 | 2006-02-21 |
| 1942846456 | Briana Gean Pope | Counselor | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-11-19 |
| 1689215717 | Traci Temples | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-09-30 |
| 1417506197 | Haley Jehree Glover | Counselor | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-09-05 |
| 1548814882 | Lindsey Paige Lamb | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-07-25 |
| 1861979494 | William Kyle Purcell | Counselor | 350 Salem Rd Ste 1, Conway, AR 72034 | 2018-07-26 |
| 1619474772 | Ashley Jane Pruitt | Registered Nurse | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2018-04-06 |
| 1922519362 | Katy Carnahan | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2017-10-12 |
| 1821508797 | Leslie Spurgers | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2017-10-05 |
| 1922517440 | Katherine Baxter | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2017-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
| Find all providers in zip 72034 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598257701 | Casondra R Robinson | Counselor | 1720 Simms St, Conway, AR 72034-6416 | 2018-06-04 |
| 1316461510 | Renew Counseling | Counselor | 1237 Front St, Conway, AR 72032-4101 | 2017-07-29 |
| 1720515638 | Poindexter Counseling LLC | Counselor | 800 Legion St Ste 200b, Conway, SC 29526-4825 | 2017-05-23 |
| 1528489192 | Scott K Grainger | Counselor | 105 Hampton Ridge Rd, Conway, SC 29527-3975 | 2013-12-26 |
| 1194158394 | Alan J Hahn | Counselor | 1308 Oak St Unit A, Conway, AR 72034-5339 | 2013-08-12 |
| 1245570845 | Lynn Smith Hucks | Counselor | 6720 Elbow Rd, Conway, SC 29527-6471 | 2013-02-20 |
| 1831494905 | Tresvil Gerard Pack | Counselor | 930 Wingate St Ste D2, Conway, AR 72034-4837 | 2011-01-20 |
| 1124239538 | Wendy J Blackwood | Counselor | 1422 Caldwell St, Conway, AR 72034-5319 | 2007-05-25 |
| 1770608598 | Lydia Willingham | Counselor | 1119 3rd Ave, Conway, SC 29526-5135 | 2007-03-20 |
| 1942300975 | Phyllis Jordan Stalvey | Counselor | 400 Laurel St, Conway, SC 29526-4317 | 2006-09-22 |
| 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.