NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER (NPI# 1326299736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326299736 |
Entity Type | Organization |
Organization Name | NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER |
Other Organization Name | MID-SOUTH HEALTH SYSTEMS, INC. |
Practice Address |
102 South Larkspur Walnut Ridge AR 72476-1736 |
Mailing Address |
2707 Browns Ln Jonesboro AR 72401-7213 |
Practice Telephone | 8708867924 |
Practice Fax Number | 8709724911 |
Mailing Telephone | 8708867924 |
Mailing Fax Number | 8709724911 |
Enumeration Date | 2008-10-03 |
Last Update Date | 2012-12-11 |
Authorized Official Name | DONNIE J LYERLY (PROVIDER CREDENTIALING) |
Authorized Official Telephone | 8709724939 |
Is Organization Subpart | Y |
Parent Organization Name | NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
Y | 251S00000X | Community/Behavioral Health | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | 172107526 | 05 |
Other Name | Type Code |
---|---|
Mid-South Health Systems, Inc. | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588957476 | Northeast Arkansas Community Mental Health Center | Counselor | 661 Addison Dr., Wynne, AR 72396 | 2011-05-25 |
1770803090 | Northeast Arkansas Community Mental Health Center | Counselor | 211 Missouri, Helena, AR 72342-3707 | 2010-06-09 |
1598916918 | Northeast Arkansas Community Mental Health Center | Counselor | 2560 Old County Rd, Pocahontas, AR 72455-4118 | 2008-10-03 |
1104077676 | Northeast Arkansas Community Mental Health Center | Counselor | 602 David St, Corning, AR 72422-7268 | 2008-10-02 |
1275784746 | Northeast Arkansas Community Mental Health Center | Counselor | 1011 W Morgan St, Paragould, AR 72450-2850 | 2008-10-02 |
1699926154 | Northeast Arkansas Community Mental Health Center | Counselor | 3700 Access Road, Jonesboro, AR 72401-7238 | 2008-10-02 |
1225321110 | Northeast Arkansas Community Mental Health Center | Counselor | 444 Atkins Blvd, Marianna, AR 72360-2110 | 2011-05-25 |
1699068585 | Northeast Arkansas Community Mental Health Center | Counselor | 801 Newman Dr, Helena, AR 72342-8950 | 2011-05-25 |
1598058489 | Northeast Arkansas Community Mental Health Center | Counselor | 905 N 7th St, West Memphis, AR 72301-2001 | 2011-05-25 |
1396038287 | Northeast Arkansas Community Mental Health Center | Counselor | 28 Southpointe Dr, Paragould, AR 72450-6238 | 2011-05-25 |
Street Address |
102 SOUTH LARKSPUR |
City | WALNUT RIDGE |
State | AR |
Zip Code | 72476-1736 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598315509 | Monica Keeley Pearcy | Case Manager/Care Coordinator | 102 South Larkspur, Walnut Ridge, AR 72476-7247 | 2019-09-12 |
1013409960 | Sadie Elizabeth Johnson | Case Manager/Care Coordinator | 102 South Larkspur, Walnut Ridge, AR 72476 | 2018-06-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871113126 | Lauren Felts | Pharmacist | 1405 W Main Suite B, Walnut Ridge, AR 72476 | 2020-04-16 |
1033609995 | Misty Dawn Colvey | Specialist/Technologist | 60 W Fulbright Avenue, Walnut Ridge, AR 72476 | 2018-05-16 |
1427570803 | Heartline Home Care LLC | Home Health | 329 West Poplar, Walnut Ridge, AR 72476 | 2017-07-07 |
1093246035 | Allyson Claire Smith | Case Manager/Care Coordinator | 1425 W Main, Walnut Ridge, AR 72476 | 2017-03-22 |
1780134098 | H4l Ranch, Inc. | Community Based Residential Treatment Facility, Mental Illness | 853 Us 63, Walnut Ridge, AR 72476 | 2016-10-11 |
1386023943 | Meghon Lanae Mink | Physical Therapist | 200 South Memorial Drive, Walnut Ridge, AR 72476 | 2015-05-28 |
1013308436 | Meaghan Danielle Kingston | Nurse Practitioner | 1045 W Main St Ste C, Walnut Ridge, AR 72476 | 2015-02-06 |
1962789826 | Amber Fawn Adams | Family Medicine | 402 Sw Larkspur Dr, Walnut Ridge, AR 72476 | 2011-11-07 |
1528348760 | Pamela Wilcoxson | Case Manager/Care Coordinator | 1425 West Main, Walnut Ridge, AR 72476 | 2011-08-19 |
1184928764 | Lauara Beth Rhein | Case Manager/Care Coordinator | 1425 West Main Street, Walnut Ridge, AR 72476 | 2010-12-22 |
Find all providers in zip 72476 |
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 |
Find all providers with the same taxonomy |
City | WALNUT RIDGE |
Zip Code | 72476 |
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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.