PSYCHOLOGICAL CARE CENTER (NPI# 1548398910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548398910 |
| Entity Type | Organization |
| Organization Name | PSYCHOLOGICAL CARE CENTER |
| Practice Address |
308 W Monroe Ave Jonesboro AR 72401-2741 |
| Practice Telephone | 8709724770 |
| Mailing Telephone | 8709724770 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GEORGE M DEROECK (PSYCHOLOGIST) |
| Authorized Official Telephone | 8709724770 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | ELECTRONIC SUBMITTER # | E3022 | 01 |
| Street Address |
308 W MONROE AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-2741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396841565 | George M De Roeck | Psychologist | 308 W Monroe Ave, Jonesboro, AR 72401-2741 | 2006-09-15 |
| 1851475701 | Cara Kriehn De Roeck | Counselor | 308 W Monroe Ave, Jonesboro, AR 72401-2741 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113650 | Secure Foundation Counseling Pllc | Clinic/Center | 125 N Fisher St, Jonesboro, AR 72401-2116 | 2020-10-31 |
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1598398802 | Bhg L, LLC | Clinic/Center | 5510 Southwest Drive, Ste 8, Jonesboro, AR 72404-8352 | 2020-02-14 |
| 1548721525 | Essential Medical and Mental Health Institute | Clinic/Center | 486 Luke Ct, Jonesboro, GA 30238-5798 | 2019-03-30 |
| 1033682612 | Gr8-xpressions Behavioral Health, LLC. | Clinic/Center | 8762 Edenton Way, Jonesboro, GA 30238-4494 | 2019-01-07 |
| 1427416577 | Life Rediscovery Center, LLC | Clinic/Center | 522 Flint Trl, Ste A, Jonesboro, GA 30236-1316 | 2016-02-03 |
| 1639358906 | Clayton Mhddad | Clinic/Center | 1585 Pintail Rd, Jonesboro, GA 30238-6641 | 2007-11-02 |
| 1679761373 | Clayton Mhddad | Clinic/Center | 2081 Logan Dr, Jonesboro, GA 30236-7215 | 2007-10-09 |
| 1851589550 | Clayton Mhddad | Clinic/Center | 7814 Fielder Rd, Jonesboro, GA 30236-2610 | 2007-10-09 |
| 1497943104 | Clayton Mhddad | Clinic/Center | 901 Walnut Creek Ln, Jonesboro, GA 30238-6465 | 2007-10-09 |
| Find all providers in JONESBORO | ||||
Please comment or provide details below to improve the information on PSYCHOLOGICAL CARE CENTER.
| 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.