INNOVATIVE PSYCHOLOGICAL SERVICES, INC. (NPI# 1558880153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558880153 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE PSYCHOLOGICAL SERVICES, INC. |
| Practice Address |
2215 Wildwood Ave Sherwood AR 72120-5089 |
| Mailing Address |
Po Box 241967 Little Rock AR 72223-0037 |
| Practice Telephone | 5012386560 |
| Mailing Telephone | 5012386560 |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. YOUSEF ARFAN FAHOUM (INCORPORATOR/ORGANIZER) |
| Authorized Official Telephone | 5012386560 |
| Authorized Official Credential | DRPH, MA, LPE-I |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 20 Marcella Dr, Little Rock, AR 722239172 | 5012386560 |
| Street Address |
2215 WILDWOOD AVE |
| City | SHERWOOD |
| State | AR |
| Zip Code | 72120-5089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942290481 | Kathryn T Chenault | Psychiatry & Neurology | 2215 Wildwood Ave, Suite 200, Sherwood, AR 72120-5089 | 2005-10-26 |
| 1205458189 | Shiloh Emergency Group Pllc | Physician Assistant | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2020-05-13 |
| 1790317220 | Jessaca Hope | Nurse Practitioner | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2020-02-12 |
| 1083176564 | Theresia Garcia | Neurological Surgery | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2019-04-03 |
| 1407359862 | Meredith Dawn Stogner | Nurse Practitioner | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2018-03-13 |
| 1720512668 | Jenna Rae Valovich | Nurse Practitioner | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2017-04-18 |
| 1134513906 | St. Vincent Infirmary Medical Center | Emergency Medicine | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2015-03-19 |
| 1609281070 | Terra Nicole Mcguire | Nurse Practitioner | 2215 Wildwood Ave, #204, Sherwood, AR 72120-5089 | 2014-06-24 |
| 1265870885 | Arkansas River Emergency Services LLC | Emergency Medicine | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2013-06-05 |
| 1255688362 | Erick L Lane | Physical Therapist | 2215 Wildwood Ave, Sherwood, AR 72120-5089 | 2012-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215409818 | Mary Kaye Hill | Physical Therapist | 6020 Warden Road, Sherwood, AR 72120 | 2018-12-20 |
| 1043714694 | Healthcare Express, LLP | Clinic/Center | 1554 Country Club Road, Sherwood, AR 72120 | 2018-03-20 |
| 1265957690 | Darryl Nathaniel Griffith | Massage Therapist | 9871 Brockington Road, Suite #1, Sherwood, AR 72120 | 2017-08-07 |
| 1669841011 | Sarah Katherine Stephenson | Pharmacist | 102 Brockington Rd, Sherwood, AR 72120 | 2015-09-16 |
| 1063803328 | The Legacy for Children and Families | Counselor | 190 Jan Drive, Suite #10, Sherwood, AR 72120 | 2015-02-09 |
| 1417297235 | Andrew Hunter Beavers | Counselor | 37 Walton Rd., Sherwood, AR 72120 | 2013-02-15 |
| 1003156886 | Infinity Hearing Center Inc. | Hearing Aid Equipment | 3115 E Kiehl Ave, Suite B, Sherwood, AR 72120 | 2013-02-15 |
| 1548543234 | Lorrie Ann George | Early Intervention Provider Agency | 207 Fred Rains Drive, Sherwood, AR 72120 | 2011-09-20 |
| 1033411897 | Tessa Monique Davis | Occupational Therapist | 21 Gunstock Lane, North Little Rock, AR 72120 | 2010-11-30 |
| 1720307903 | Yousef Arfan Fahoum | Psychologist | 2215 Wildwood Ave Ste 200, Sherwood, AR 72120 | 2010-05-27 |
| Find all providers in zip 72120 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477716637 | Neuropsychology, Inc. | Clinic/Center | 2201 Wildwood Ave, Sherwood, AR 72120-5074 | 2008-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656099 | Life Strategies Counseling, Inc. | Clinic/Center | 112 N Bettis St, Pocahontas, AR 72455-3301 | 2020-10-15 |
| 1932706918 | Village Counseling LLC | Clinic/Center | 13 Belleza Way, Hot Springs Village, AR 71909-7911 | 2020-10-03 |
| 1487205357 | Central Arkansas Psychological Services | Clinic/Center | 523 N University Ave, Little Rock, AR 72205-2916 | 2019-09-23 |
| 1548723547 | Christa Means Counseling Services | Clinic/Center | 1800 Hendricks Blvd, Fort Smith, AR 72903-3414 | 2019-04-08 |
| 1992289268 | Cassandra Warden Corporation | Clinic/Center | 721 Norma Ln, Ozark, AR 72949-4126 | 2018-09-21 |
| 1134606304 | Pace Psychotherapy | Clinic/Center | 1605 N Fillmore St, Little Rock, AR 72207-5343 | 2018-07-20 |
| 1659863967 | Rising Lotus Therapy Services, Pllc | Clinic/Center | 1401 Malvern Ave Ste 200a, Hot Springs, AR 71901-6371 | 2018-06-01 |
| 1215444963 | Souls Harbor of Rogers Inc. | Clinic/Center | 1206 N 2nd St, Rogers, AR 72756-2836 | 2018-01-03 |
| 1538674932 | Pathways Counseling, Pllc | Clinic/Center | 5540 Lexington Ave, Benton, AR 72019-1834 | 2017-12-06 |
| 1306374350 | Sarah Elizabeth Gibson | Clinic/Center | 172 Longview Cir, Searcy, AR 72143-9215 | 2017-06-02 |
| Find all providers with the same taxonomy | ||||
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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.