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10618 Breckenridge Dr Little Rock AR 72211-1802 | |
| (501) 217-8600 | |
| (501) 217-8636 |
| Full Name | |
|---|---|
| Speciality | Speech-Language Pathologist |
| Location | 10618 Breckenridge Dr, Little Rock, Arkansas |
| Authorized Official Name and Position | Shalene S. Hammons (ADMINISTRATIVE EXECUTIVE ASSISTANT) |
| Authorized Official Contact | 5012178600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
10618 Breckenridge Dr Little Rock AR 72211-1802 Ph: (501) 217-8600 | 10618 Breckenridge Dr Little Rock AR 72211-1802 Ph: (501) 217-8600 |
| NPI Number | 1881738409 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 10/23/2024 |
| Certification Date | 10/23/2024 |
| Medicare PECOS PAC ID | 8325402613 |
|---|---|
| Medicare Enrollment ID | O20230920000762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881738409 | NPI | - | NPPES |
| 5B944 | Other | AR | BCBS |
| 131193742 | Medicaid | AR |
| Provider Name | Emily M Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093049447 PECOS PAC ID: 2769603760 Enrollment ID: I20141016000225 |
| Provider Name | Susan Hill |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1366619462 PECOS PAC ID: 4284097544 Enrollment ID: I20230905000545 |
| Provider Name | Brittney Richardson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841967882 PECOS PAC ID: 0244693521 Enrollment ID: I20230905001472 |
| Provider Name | Amber Mccall |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427344456 PECOS PAC ID: 2567825854 Enrollment ID: I20230905001695 |
| Provider Name | Kristina Rupp |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710035092 PECOS PAC ID: 2062875362 Enrollment ID: I20230905001987 |
| Provider Name | Caressa Corine Wilson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851163380 PECOS PAC ID: 8921539727 Enrollment ID: I20241003003371 |
| Provider Name | Megan D Burrow |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548776115 PECOS PAC ID: 5698206407 Enrollment ID: I20241003003706 |
| Provider Name | Sarah D Jarvis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598095614 PECOS PAC ID: 9537690342 Enrollment ID: I20241003003978 |
| Provider Name | Emily Price |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1023788338 PECOS PAC ID: 1759814510 Enrollment ID: I20241031002529 |
| Provider Name | Kelsea Renea Sherrick |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1922654995 PECOS PAC ID: 1658805064 Enrollment ID: I20241107002411 |
| Provider Name | Alicia Pattillo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1750601076 PECOS PAC ID: 3577097641 Enrollment ID: I20241112002331 |
| Provider Name | Tynesha Ivory |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669814745 PECOS PAC ID: 3971039009 Enrollment ID: I20241211004760 |
State Of The Heart Counseling Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7123 I-30, Suite 6, Little Rock, AR 72209 Phone: 501-414-0070 | |
Jill Gorman Lpc Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 N University Ave Ste 700, Little Rock, AR 72207 Phone: 817-681-0069 | |
Little Rock Counseling, Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 Breckenridge Dr Ste 107, Little Rock, AR 72205 Phone: 501-303-6838 Fax: 501-232-1427 | |
Apollo Health, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11715 Rainwood Rd Ste B6, Little Rock, AR 72212 Phone: 479-242-1003 Fax: 479-782-5502 | |
Centers For Youth And Families, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1521 Merrill Drive, Suite D220 And E200, Little Rock, AR 72211 Phone: 501-666-8686 | |
Grace Place Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 W 3rd St Ste 612, Little Rock, AR 72205 Phone: 501-551-0268 Fax: 949-862-5322 | |
Mission Psychotherapy Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 W 2nd St Ste 110, Little Rock, AR 72201 Phone: 501-672-5341 |