Jamie Lee Gordon, LPC-S | |
920 Mitchell St, Conway, AR 72034-5148 | |
(501) 620-0162 | |
Not Available |
Full Name | Jamie Lee Gordon |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 920 Mitchell St, Conway, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649383886 | NPI | - | NPPES |
1639558398 | Other | NPPES | |
1639558398 | Other | AR | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | P0509059 (Arkansas) | Primary |
Entity Name | Counseling Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649381120 PECOS PAC ID: 3173583564 Enrollment ID: O20041011000417 |
Entity Name | Simple Soul Counseling Services, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164144812 PECOS PAC ID: 6305205329 Enrollment ID: O20231028000160 |
Mailing Address | Practice Location Address |
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Jamie Lee Gordon, LPC-S 920 Mitchell St, Conway, AR 72034-5148 Ph: (501) 620-0162 | Jamie Lee Gordon, LPC-S 920 Mitchell St, Conway, AR 72034-5148 Ph: (501) 620-0162 |
Mary Louise Strain, MS LICENSED PSYCHOLO Counselor Medicare: Not Enrolled in Medicare Practice Location: 350 Salem Road Suite 1, Conway, AR 72034 Phone: 501-336-8300 Fax: 501-329-3572 | |
Todd Mcguire, Counselor Medicare: Medicare Enrolled Practice Location: 132 Lower Ridge Rd, Conway, AR 72032 Phone: 501-315-3344 | |
Alison Kay Tutt, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1601 Hogan Ln Apt 2001, Conway, AR 72034 Phone: 479-747-5290 | |
Carol Marie Kretzmann, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 132 Lower Ridge Rd, Conway, AR 72032 Phone: 501-548-9905 | |
James V Fudoli, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 350 Salem Road, Suite 1, Conway, AR 72034 Phone: 501-336-8300 Fax: 501-329-3572 | |
Mr. Collin Thomas Davies, M.A., LPE-I Counselor Medicare: Not Enrolled in Medicare Practice Location: 2850 Prince St Ste 53, Conway, AR 72034 Phone: 501-764-3002 Fax: 866-514-7628 | |
Jeff Koehn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 132 Lower Ridge Rd, Conway, AR 72032 Phone: 501-221-1941 |