EBONY LATREACE CHARLESTON


Address: 3240 Stermer Road, Conway, AR 72034
Phone: 5013271701

EBONY LATREACE CHARLESTON (NPI# 1508371865) 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) 1508371865
Entity Type Individual
Full Name EBONY LATREACE CHARLESTON
Other Name EBONY L FORD
Credential QBHP
Practice Address 3240 Stermer Road
Conway
AR 72034
Mailing Address 110 Skyline Dr
Russellville
AR 72801-3362
Practice Telephone 5013271701
Practice Fax Number 5013295508
Mailing Telephone 4799675570
Mailing Fax Number 4798905364
Enumeration Date 2017-12-08
Last Update Date 2020-01-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171M00000X Case Manager/Care Coordinator Other Service Providers

Office Location

Street Address 3240 STERMER ROAD
City CONWAY
State AR
Zip Code 72034

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215567698 Olivia Anna-camille Stokes Case Manager/Care Coordinator 3240 Stermer Road, Conway, AR 72034 2020-01-24
1669011128 Lyndsee Marie Burleson Case Manager/Care Coordinator 3240 Stermer Road, Conway, AR 72034 2020-01-02
1811536634 Dominique Deaju Vinson Case Manager/Care Coordinator 3240 Stermer Road, Conway, AR 72034 2019-12-26
1265070718 Laura Grace Lefevre Case Manager/Care Coordinator 3240 Stermer Road, Conway, AR 72034 2019-12-16
1104472943 Savannah Shankles Case Manager/Care Coordinator 3240 Stermer Road, Conway, AR 72032 2019-08-16
1295387942 Paula Mainard Social Worker 3240 Stermer Road, Conway, AR 72032 2019-07-12

Providers in the same zip code

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
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
1033657382 Heath Bryan Coleman, Dds of Arkansas II, Pllc Dentist 635 Dave Ward Drive, Ste 101, Conway, AR 72034 2017-02-07
Find all providers in zip 72034

Taxonomy Information

Taxonomy Code 171M00000X
Grouping Other Service Providers
Classification Case Manager/Care Coordinator

Taxonomy Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013563758 Shelby M Perez Case Manager/Care Coordinator 3240 Stermer Rd, Conway, AR 72034 2019-08-16
1720516289 Wendy A Magbanua Case Manager/Care Coordinator 317 Lower Ridge Rd, Conway, AR 72035-0001 2017-05-30
1538609417 Eric Dillinger Case Manager/Care Coordinator 61 Winding Branch Ln, Conway, AR 72032-8701 2017-02-27
1023487097 Comeatrieze Vantelia Ester Case Manager/Care Coordinator 816 N. Creek Dr., Conway, AR 72032 2015-09-21
1275938615 Ian Evans Case Manager/Care Coordinator 818 N. Creek Dr., Conway, AR 72032 2014-10-28
1982007977 Tina Boone Case Manager/Care Coordinator 816 N. Creek Dr, Conway, AR 72032 2014-10-03
1154738110 Brittney Morgan Wood Case Manager/Care Coordinator 2175 B Rosemary Drive, Conway, AR 72034 2014-07-22
1063779437 Sara Coleta Garland Case Manager/Care Coordinator 1100 Bob Courtway Dr # Dre, Suite 9, Conway, AR 72032-4766 2012-04-23
1427363209 Careteam Plus, Inc. Case Manager/Care Coordinator 100 Professional Park Drive, Conway, SC 29526-9260 2010-08-17
1689904377 Amanda Ruby Jane Troutman Case Manager/Care Coordinator 123 Lower Ridge Rd, Conway, AR 72032-8518 2010-01-04
Find all providers in CONWAY

Competitor

Search similar providers

City CONWAY
Zip Code 72034

Improve Information

Please comment or provide details below to improve the information on EBONY LATREACE CHARLESTON.

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.

Trending Searches