| Pathfinder, Inc. | |
|
2411 W Main St Jacksonville AR 72076-4211 | |
| (501) 982-0528 | |
| (501) 985-1462 |
| Full Name | Pathfinder, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2411 W Main St, Jacksonville, Arkansas |
| Authorized Official Name and Position | James C Green (DIRECTOR) |
| Authorized Official Contact | 5019820528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathfinder, Inc. Po Box 647 Jacksonville AR 72078-0647 Ph: (501) 982-0528 | Pathfinder, Inc. 2411 W Main St Jacksonville AR 72076-4211 Ph: (501) 982-0528 |
| NPI Number | 1629035043 |
|---|---|
| Provider Enumeration Date | 04/28/2006 |
| Last Update Date | 11/12/2020 |
| Certification Date | 11/12/2020 |
| Medicare PECOS PAC ID | 8628061801 |
|---|---|
| Medicare Enrollment ID | O20040405000779 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629035043 | NPI | - | NPPES |
| 150200726 | Medicaid | AR | |
| 150203726 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Darlene P Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427160910 PECOS PAC ID: 5496712408 Enrollment ID: I20041210000908 |
| Provider Name | Jacquelyn P Bearden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043373616 PECOS PAC ID: 9537251319 Enrollment ID: I20070824000209 |
| Provider Name | Bethany Steele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639206014 PECOS PAC ID: 5092097378 Enrollment ID: I20170120002225 |
| Provider Name | Silas E Murders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336566009 PECOS PAC ID: 1759781511 Enrollment ID: I20210616000110 |
| Provider Name | Jonathan Edwin Waddell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457838187 PECOS PAC ID: 8921496654 Enrollment ID: I20211028001680 |
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