| Arkansas Counseling And Psychodiagnostics, Inc. | |
|
2607 Caddo St Ste 6 Arkadelphia AR 71923-5307 | |
| (870) 230-8217 | |
| (870) 230-8201 |
| Full Name | Arkansas Counseling And Psychodiagnostics, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2607 Caddo St Ste 6, Arkadelphia, Arkansas |
| Authorized Official Name and Position | Charles Adolph Weiner (VICE PRESIDENT AND CCO) |
| Authorized Official Contact | 8702303404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arkansas Counseling And Psychodiagnostics, Inc. 2607 Caddo St Ste 6 Arkadelphia AR 71923-5307 Ph: (870) 230-8217 | Arkansas Counseling And Psychodiagnostics, Inc. 2607 Caddo St Ste 6 Arkadelphia AR 71923-5307 Ph: (870) 230-8217 |
| NPI Number | 1902060684 |
|---|---|
| Provider Enumeration Date | 07/11/2008 |
| Last Update Date | 12/16/2020 |
| Certification Date | 12/16/2020 |
| Medicare PECOS PAC ID | 0446470124 |
|---|---|
| Medicare Enrollment ID | O20140930002778 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902060684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | James W Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841684073 PECOS PAC ID: 4082922356 Enrollment ID: I20161024002643 |
| Provider Name | Mary Elizabeth O'donovan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164654919 PECOS PAC ID: 2860890969 Enrollment ID: I20211004002075 |
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