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801 Carlton St Springdale AR 72762-5105 | |
| (479) 255-5414 | |
| (855) 277-8988 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 801 Carlton St, Springdale, Arkansas |
| Authorized Official Name and Position | Andrea Neuls (AM) |
| Authorized Official Contact | 5185710867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
801 Carlton St Springdale AR 72762-5105 Ph: (479) 466-3783 | 801 Carlton St Springdale AR 72762-5105 Ph: (479) 255-5414 |
| NPI Number | 1881197697 |
|---|---|
| Provider Enumeration Date | 03/18/2018 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 8325394604 |
|---|---|
| Medicare Enrollment ID | O20180628000834 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881197697 | NPI | - | NPPES |
| Provider Name | Debra Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942496302 PECOS PAC ID: 4587791868 Enrollment ID: I20100419000100 |
| Provider Name | Laura Lee Mendenhall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134377583 PECOS PAC ID: 8123301900 Enrollment ID: I20170202001114 |
| Provider Name | Shealtiel Blu Kuykendall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073977476 PECOS PAC ID: 6406108646 Enrollment ID: I20181016002747 |
| Provider Name | Tayler Elizabeth Pollock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881114320 PECOS PAC ID: 6002248663 Enrollment ID: I20191120000381 |
| Provider Name | Denise Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730716887 PECOS PAC ID: 9133540545 Enrollment ID: I20200610001249 |
| Provider Name | Mysti H Burton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831353002 PECOS PAC ID: 7416346101 Enrollment ID: I20211118001648 |
| Provider Name | Reba M Byrd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457739898 PECOS PAC ID: 0345631073 Enrollment ID: I20220106001482 |
| Provider Name | Jason Robert Cates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942920947 PECOS PAC ID: 1557805314 Enrollment ID: I20240703001913 |
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