MR. CRYSTAL LOUISE KAVANAUGH (NPI# 1447380712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447380712 |
| Entity Type | Individual |
| Full Name | MR. CRYSTAL LOUISE KAVANAUGH |
| Credential | LPE (PROVISIONAL) |
| Practice Address |
5905 Forest Pl Little Rock AR 72207-5244 |
| Mailing Address |
Po Box 251970 Little Rock AR 72225-1970 |
| Practice Telephone | 5016664949 |
| Mailing Telephone | 5016668686 |
| Mailing Fax Number | 5016606830 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
PROVISIONAL | AR | Behavioral Health & Social Service Providers |
| Street Address |
5905 FOREST PL |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72207-5244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154370518 | Zarina Shah | Psychiatry & Neurology | 5905 Forest Pl, Centers for Youth and Families, Suite 210, Little Rock, AR 72207-5245 | 2006-05-10 |
| 1508226788 | Nancy Mumma Streit Atkinson | Social Worker | 5905 Forest Pl, Suite 230, Little Rock, AR 72207-5244 | 2016-03-01 |
| 1265897946 | Riverstone Wellness Center, Pllc | Social Worker | 5905 Forest Pl, Suite 230, Little Rock, AR 72207-5244 | 2015-12-22 |
| 1265853956 | Brandy Moore | Counselor | 5905 Forest Pl, Little Rock, AR 72207-5244 | 2013-12-23 |
| 1538408406 | Leslie Jewel Chesshir | Social Worker | 5905 Forest Pl, Suite 100, Little Rock, AR 72207-5244 | 2013-02-12 |
| 1811241276 | Leeann Woodrum-oakley | Social Worker | 5905 Forest Pl, Little Rock, AR 72207-5244 | 2012-11-06 |
| 1487897872 | Jose M Pavao | Case Manager/Care Coordinator | 5905 Forest Pl, Little Rock, AR 72207-5244 | 2009-04-14 |
| 1669615050 | Rita Ann Jordan | Case Manager/Care Coordinator | 5905 Forest Pl, Little Rock, AR 72207-5244 | 2009-04-14 |
| 1659516185 | Erika Michelle Trammell | Case Manager/Care Coordinator | 5905 Forest Pl, Little Rock, AR 72207-5244 | 2008-12-12 |
| 1548414477 | Daniel R Field | Case Manager/Care Coordinator | 5905 Forest Pl, Suite 100, Little Rock, AR 72207-5244 | 2008-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245754555 | Yolanda Johnson | Case Manager/Care Coordinator | 1100 N University Suite 200, Little Rock, AR 72207 | 2017-07-28 |
| 1275065146 | Mccallum Medical Pa | Emergency Medicine | 1923 N Tyler St, Little Rock, AR 72207 | 2017-03-30 |
| 1700326790 | Denira Zardoost | Case Manager/Care Coordinator | 1100 N.uiversity, Evergreen Place Suite 200, Little Rock, AR 72207 | 2017-02-24 |
| 1952794828 | Robert Young Md | Clinic/Center | 4617 Crestwood Dr, Little Rock, AR 72207 | 2015-03-16 |
| 1366711004 | Amanda Diane Berg | Massage Therapist | 1405 N. Pierce St., Suite 210, Little Rock, AR 72207 | 2011-12-27 |
| 1801184080 | Larra Jean Bender | Massage Therapist | 1405 N. Pierce St. Suite 210, Little Rock, AR 72207 | 2011-07-21 |
| 1326371550 | Elizabeth G White | Social Worker | 1501 N University Ave Ste 416, Little Rock, AR 72207 | 2009-09-04 |
| 1437334364 | Lori Lamitina Nicholson | Chiropractor | 1405 North Pierce Street, Suite 210, Little Rock, AR 72207 | 2008-01-09 |
| 1568656858 | Megan Elizabeth Hughes | Social Worker | 5905 Forest Place, Little Rock, AR 72207 | 2007-08-30 |
| 1336361955 | Jennifer Baldwin | Occupational Therapist | 7204 M St, Little Rock, AR 72207 | 2007-05-03 |
| Find all providers in zip 72207 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003425703 | Apollo Health, LLC | Counselor | 11715 Rainwood Rd Ste B6, Little Rock, AR 72212-3968 | 2020-07-28 |
| 1376168120 | Shea Wood | Counselor | 8 Shackleford Plz Ste 206, Little Rock, AR 72211-1853 | 2020-06-08 |
| 1740803683 | Ryan Russ LLC | Counselor | 1900 N Bryant St Ste 310, Little Rock, AR 72207-5022 | 2020-05-27 |
| 1003443953 | David Laser Jr. | Counselor | 3700 W 65th St, Little Rock, AR 72209-8552 | 2020-03-23 |
| 1992331508 | Seth Thomas Gilleran | Counselor | 14710 Cantrell Rd Ste 7a, Little Rock, AR 72223-4253 | 2020-03-14 |
| 1568004240 | Cheyenne Parker | Counselor | 20400 Col Glenn Road Youth Home, Inc., Little Rock, AR 72210-5323 | 2019-10-14 |
| 1104473198 | Carrie Teresa Calhoon | Counselor | 1100 N University Ave Ste 137, Little Rock, AR 72207-6344 | 2019-08-23 |
| 1730668864 | Raysha Clark | Counselor | 10515 W Markham St Ste K4, Little Rock, AR 72205-2287 | 2018-08-09 |
| 1003306804 | Chris Beasley | Counselor | 9819 Margie Cir, Little Rock, AR 72209-6521 | 2018-05-16 |
| 1841787090 | Martin Counseling Services, LLC | Counselor | 1100 N University Ave Ste 210, Little Rock, AR 72207-6359 | 2018-04-13 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72207 |
Please comment or provide details below to improve the information on MR. CRYSTAL LOUISE KAVANAUGH.
| 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.