| Life Strategies Of Arkansas, Llc | |
|
304 N 6th St West Memphis AR 72301 | |
| (870) 732-1878 | |
| (870) 702-7111 |
| Full Name | Life Strategies Of Arkansas, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 304 N 6th St, West Memphis, Arkansas |
| Authorized Official Name and Position | Rick Draper (CEO) |
| Authorized Official Contact | 8707321878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Strategies Of Arkansas, Llc 304 N 6th St West Memphis AR 72301-3221 Ph: (870) 732-1878 | Life Strategies Of Arkansas, Llc 304 N 6th St West Memphis AR 72301 Ph: (870) 732-1878 |
| NPI Number | 1700950011 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 10/22/2019 |
| Medicare PECOS PAC ID | 1658360995 |
|---|---|
| Medicare Enrollment ID | O20040511000740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700950011 | NPI | - | NPPES |
| 160409526 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Arkansas) | Primary |
| Provider Name | Donald L Mcdonald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376568139 PECOS PAC ID: 4981693231 Enrollment ID: I20080227000839 |
| Provider Name | Carissa Nicole Bacon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437560679 PECOS PAC ID: 4789952375 Enrollment ID: I20170623000355 |
| Provider Name | Courtney Myrick Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558777896 PECOS PAC ID: 7012275779 Enrollment ID: I20171229001780 |
| Provider Name | Sarah Elizabeth Bean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255987699 PECOS PAC ID: 0143559898 Enrollment ID: I20190905003554 |
| Provider Name | Theresa A James |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659911980 PECOS PAC ID: 3577952886 Enrollment ID: I20211108001223 |
| Provider Name | Samantha Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396492393 PECOS PAC ID: 1557757689 Enrollment ID: I20220329002611 |
| Provider Name | Shameeka Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588211064 PECOS PAC ID: 3274901053 Enrollment ID: I20221129001657 |
| Provider Name | Casey Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760677272 PECOS PAC ID: 7517318389 Enrollment ID: I20240105000525 |
| Provider Name | Aretha Fulcher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487957635 PECOS PAC ID: 1355792896 Enrollment ID: I20240109001319 |
| Provider Name | Kevin Lemore Clark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538317482 PECOS PAC ID: 2062855901 Enrollment ID: I20240208000590 |
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