| Conway Branch | |
|
132 Lower Ridge Rd Conway AR 72032-8518 | |
| (501) 548-9905 | |
| Not Available |
| Full Name | Conway Branch |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 132 Lower Ridge Rd, Conway, Arkansas |
| Authorized Official Name and Position | Rolando Garcia (CFO) |
| Authorized Official Contact | 5013153344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway Branch Po Box 1589 Benton AR 72018-1589 Ph: (501) 315-3344 | Conway Branch 132 Lower Ridge Rd Conway AR 72032-8518 Ph: (501) 548-9905 |
| NPI Number | 1770733768 |
|---|---|
| Provider Enumeration Date | 09/25/2008 |
| Last Update Date | 08/09/2010 |
| Medicare PECOS PAC ID | 5597749747 |
|---|---|
| Medicare Enrollment ID | O20040615001261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770733768 | NPI | - | NPPES |
| 116374726 | Medicaid | AR | |
| 171628526 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Arkansas) | Primary |
| Provider Name | Kenneth D Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215978770 PECOS PAC ID: 1254316185 Enrollment ID: I20040623000888 |
| Provider Name | Coy E Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134259872 PECOS PAC ID: 6901854199 Enrollment ID: I20050104000879 |
| Provider Name | Bradford Holloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831157148 PECOS PAC ID: 6204900301 Enrollment ID: I20080807000548 |
| Provider Name | Henry Matinchek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346295318 PECOS PAC ID: 2860518016 Enrollment ID: I20100925000121 |
| Provider Name | Andrew Jay Keough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851628481 PECOS PAC ID: 1355662487 Enrollment ID: I20150602000596 |
| Provider Name | Rhonda Teneal Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083824452 PECOS PAC ID: 0042599979 Enrollment ID: I20161117001285 |
| Provider Name | Kristan Crain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134543531 PECOS PAC ID: 1456692847 Enrollment ID: I20190412000134 |
| Provider Name | Cynthia Shuffield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518593250 PECOS PAC ID: 1850702739 Enrollment ID: I20201125000754 |
| Provider Name | Sarah Augusta Testa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326530148 PECOS PAC ID: 6507279403 Enrollment ID: I20210114001336 |
| Provider Name | Richard Andrew Dwiggins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801243357 PECOS PAC ID: 3577978238 Enrollment ID: I20210211000616 |
| Provider Name | Michael Brandon Godfrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922602358 PECOS PAC ID: 2961898390 Enrollment ID: I20220411002143 |
| Provider Name | Angella Watson-mchalffey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306426150 PECOS PAC ID: 0648635029 Enrollment ID: I20230509000738 |
| Provider Name | Dustin Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679820278 PECOS PAC ID: 3274987672 Enrollment ID: I20231003002094 |
| Provider Name | Sarah Albert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518424472 PECOS PAC ID: 6800245044 Enrollment ID: I20231213000325 |
| Provider Name | Robert Mcgehee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548812472 PECOS PAC ID: 6305297078 Enrollment ID: I20240106000160 |
| Provider Name | Andrew Donovan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972043792 PECOS PAC ID: 1658722343 Enrollment ID: I20240106000649 |
| Provider Name | Christopher Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558545897 PECOS PAC ID: 2264883958 Enrollment ID: I20240106000760 |
| Provider Name | Merinda Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992914832 PECOS PAC ID: 2163873852 Enrollment ID: I20240106000788 |
| Provider Name | Kendra Metcalf |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841624921 PECOS PAC ID: 1355792961 Enrollment ID: I20240109000083 |
| Provider Name | Beth Forst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710513916 PECOS PAC ID: 8628420544 Enrollment ID: I20240116004505 |
| Provider Name | Christie Owen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861607319 PECOS PAC ID: 1254783178 Enrollment ID: I20240116004539 |
| Provider Name | Emily King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437503307 PECOS PAC ID: 1658724307 Enrollment ID: I20240129003987 |
| Provider Name | Todd Mcguire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013349208 PECOS PAC ID: 9830542513 Enrollment ID: I20240130000154 |
| Provider Name | Emma Mccarley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477854420 PECOS PAC ID: 7315380334 Enrollment ID: I20240207000595 |
| Provider Name | Katherine Wingfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902481062 PECOS PAC ID: 2062856446 Enrollment ID: I20240214001699 |
| Provider Name | Ashley Crismon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750032785 PECOS PAC ID: 5294174504 Enrollment ID: I20240419001184 |
| Provider Name | Lauren Chambless |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679230346 PECOS PAC ID: 5597207423 Enrollment ID: I20240606004341 |
Dayspring Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Bruce St, Conway, AR 72034 Phone: 501-336-0100 Fax: 501-336-0115 | |
An Embraced Life Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1422 Caldwell St, Suite H, Conway, AR 72034 Phone: 501-499-9231 Fax: 501-904-4373 | |
Catalyst Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 930 Wingate St Ste E2, Conway, AR 72034 Phone: 501-500-4114 Fax: 501-764-4555 | |
Community Service Inc. - Conway Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 818 N Creek Dr, Conway, AR 72032 Phone: 501-327-9788 Fax: 501-327-9843 | |
Wellnite Medical Group Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2395 Prince St, Conway, AR 72034 Phone: 341-888-7637 | |
Therapy Assessment Center, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 317 Oak St Ste 3, Conway, AR 72032 Phone: 501-291-3091 Fax: 501-588-0484 | |
Lighted Path Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1124 Oak St, Suite 250, Conway, AR 72032 Phone: 804-592-1205 Fax: 866-388-8128 |