Mr Kevin Lemore Clark, MHPP | |
417 W Main St, Ste B, Trumann, AR 72472-3116 | |
(870) 483-7039 | |
(870) 483-0590 |
Full Name | Mr Kevin Lemore Clark |
---|---|
Gender | Male |
Speciality | Counselor |
Location | 417 W Main St, Trumann, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538317482 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Entity Name | Life Strategies Of Arkansas Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700950011 PECOS PAC ID: 1658360995 Enrollment ID: O20040511000740 |
Mailing Address | Practice Location Address |
---|---|
Mr Kevin Lemore Clark, MHPP 5537 Bleaux Ave, Springdale, AR 72762-0737 Ph: (479) 872-5580 | Mr Kevin Lemore Clark, MHPP 417 W Main St, Ste B, Trumann, AR 72472-3116 Ph: (870) 483-7039 |
Tanika Pruitt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 417 W Main St, Ste B, Trumann, AR 72472 Phone: 870-483-7039 | |
Taylor Patrick Moore, Counselor Medicare: Not Enrolled in Medicare Practice Location: 809 W Main St Ste C-d, Trumann, AR 72472 Phone: 870-483-0068 Fax: 870-483-0066 | |
Reginald Chandler, LPC Counselor Medicare: Medicare Enrolled Practice Location: 809 W Main St Ste C-d, Trumann, AR 72472 Phone: 870-483-0068 Fax: 870-483-0066 | |
Mrs. Laura Jean Jumper, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 809 W Main St Ste C-d, Trumann, AR 72472 Phone: 870-483-0068 Fax: 870-483-0066 | |
Tarsher Lofton, Counselor Medicare: Not Enrolled in Medicare Practice Location: 417 W Main St Ste B, Trumann, AR 72472 Phone: 870-483-7039 | |
Kelton Doggett, Counselor Medicare: Not Enrolled in Medicare Practice Location: 417 W Main St Ste B, Trumann, AR 72472 Phone: 870-483-7039 Fax: 870-483-0590 | |
Symanthia Bryant, Counselor Medicare: Not Enrolled in Medicare Practice Location: 339 Highway 463 N, Trumann, AR 72472 Phone: 870-483-7039 Fax: 870-483-0590 |