Psychology & Counseling Associates | |
1 W Sunbridge Dr Fayetteville AR 72703-1825 | |
(479) 443-5575 | |
(479) 443-9554 |
Full Name | Psychology & Counseling Associates |
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Speciality | Psychologist |
Location | 1 W Sunbridge Dr, Fayetteville, Arkansas |
Authorized Official Name and Position | Lavonna M Latta (OFFICE MANAGER) |
Authorized Official Contact | 4794435575 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Psychology & Counseling Associates 1 W Sunbridge Dr Fayetteville AR 72703-1825 Ph: (479) 443-5575 | Psychology & Counseling Associates 1 W Sunbridge Dr Fayetteville AR 72703-1825 Ph: (479) 443-5575 |
NPI Number | 1205976099 |
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Provider Enumeration Date | 02/08/2007 |
Last Update Date | 04/14/2011 |
Medicare PECOS PAC ID | 8820071418 |
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Medicare Enrollment ID | O20120501000220 |
Identifier | Type | State | Issuer |
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1205976099 | NPI | - | NPPES |
5T520 | Other | AR | BLUECROSS BLUESHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 97-04P (Arkansas) | Primary |
Provider Name | Susan L Shackelford |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1427081454 PECOS PAC ID: 4284896655 Enrollment ID: I20120501000242 |
Provider Name | Kristen Dennyae Mccray |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1295147676 PECOS PAC ID: 6901154954 Enrollment ID: I20180807002949 |
Provider Name | Kamie C Meeks |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1801920442 PECOS PAC ID: 0840650438 Enrollment ID: I20230713003837 |
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