| Pulaski County Regional Crisis Stabilization Unit | |
|
3001 W Roosevelt Rd Little Rock AR 72204-5658 | |
| (501) 340-6646 | |
| (501) 975-4129 |
| Full Name | Pulaski County Regional Crisis Stabilization Unit |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 3001 W Roosevelt Rd, Little Rock, Arkansas |
| Authorized Official Name and Position | Amanda D George (VICE CHANCELLOR-CHIEF FINANCIAL OFF) |
| Authorized Official Contact | 5016865670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pulaski County Regional Crisis Stabilization Unit Po Box 251420 Little Rock AR 72225-1420 Ph: (501) 686-8000 | Pulaski County Regional Crisis Stabilization Unit 3001 W Roosevelt Rd Little Rock AR 72204-5658 Ph: (501) 340-6646 |
| NPI Number | 1871091355 |
|---|---|
| Provider Enumeration Date | 01/30/2018 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Medicare PECOS PAC ID | 4082528955 |
|---|---|
| Medicare Enrollment ID | O20181015002214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871091355 | NPI | - | NPPES |
| 230651526 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
| Provider Name | Michelle L Moseley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881636967 PECOS PAC ID: 6901881069 Enrollment ID: I20040622001281 |
| Provider Name | Joseph B Guise |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548350119 PECOS PAC ID: 5698742898 Enrollment ID: I20040916000387 |
| Provider Name | Michael J Mancino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447340013 PECOS PAC ID: 5890735427 Enrollment ID: I20050503001116 |
| Provider Name | Michelle W Krause |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1639269111 PECOS PAC ID: 7315973757 Enrollment ID: I20050715001104 |
| Provider Name | Jeffrey L Clothier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518979293 PECOS PAC ID: 4284705930 Enrollment ID: I20080624000283 |
| Provider Name | Lisa J Evans |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609011477 PECOS PAC ID: 5092872101 Enrollment ID: I20090317000247 |
| Provider Name | Craig S Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265641914 PECOS PAC ID: 5193866564 Enrollment ID: I20100107000128 |
| Provider Name | Jon Rubenow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013970797 PECOS PAC ID: 6507944030 Enrollment ID: I20100903000319 |
| Provider Name | Lou A Eads |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154411627 PECOS PAC ID: 1052596632 Enrollment ID: I20110425000744 |
| Provider Name | Christopher S Cargile |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285724856 PECOS PAC ID: 6800951609 Enrollment ID: I20121105000021 |
| Provider Name | Shona L Ray-griffith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144463423 PECOS PAC ID: 9335383777 Enrollment ID: I20130925000052 |
| Provider Name | Jessica L Coker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215295308 PECOS PAC ID: 6406171297 Enrollment ID: I20160609000590 |
| Provider Name | Lori D Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366876633 PECOS PAC ID: 1557638806 Enrollment ID: I20170517001467 |
| Provider Name | Srinivasa B Gokarakonda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447679030 PECOS PAC ID: 9830414630 Enrollment ID: I20170607000424 |
| Provider Name | Megan R Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639569809 PECOS PAC ID: 3072851344 Enrollment ID: I20190219000779 |
| Provider Name | Leshia Fox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194201400 PECOS PAC ID: 4688085673 Enrollment ID: I20201123003413 |
| Provider Name | Kizzie Houston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225620149 PECOS PAC ID: 7517374820 Enrollment ID: I20210405000994 |
| Provider Name | Danielle Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104401025 PECOS PAC ID: 4183023880 Enrollment ID: I20210601000512 |
| Provider Name | Kelli Amber Marengo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821669979 PECOS PAC ID: 3274939012 Enrollment ID: I20210902002212 |
| Provider Name | Brian Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811007081 PECOS PAC ID: 0547287906 Enrollment ID: I20211216002395 |
| Provider Name | Eric Rowshawn Luster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003564154 PECOS PAC ID: 8426445230 Enrollment ID: I20220426002144 |
| Provider Name | Abigail Barbara Richison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720519085 PECOS PAC ID: 8628349594 Enrollment ID: I20220831000435 |
| Provider Name | Paula C Quattlebaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487376935 PECOS PAC ID: 9638547540 Enrollment ID: I20221128001730 |
State Of The Heart Counseling Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7123 I-30, Suite 6, Little Rock, AR 72209 Phone: 501-414-0070 | |
Jill Gorman Lpc Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 N University Ave Ste 700, Little Rock, AR 72207 Phone: 817-681-0069 | |
Little Rock Counseling, Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 Breckenridge Dr Ste 107, Little Rock, AR 72205 Phone: 501-303-6838 Fax: 501-232-1427 | |
Apollo Health, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11715 Rainwood Rd Ste B6, Little Rock, AR 72212 Phone: 479-242-1003 Fax: 479-782-5502 | |
Centers For Youth And Families, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1521 Merrill Drive, Suite D220 And E200, Little Rock, AR 72211 Phone: 501-666-8686 | |
Grace Place Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 W 3rd St Ste 612, Little Rock, AR 72205 Phone: 501-551-0268 Fax: 949-862-5322 | |
Mission Psychotherapy Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 W 2nd St Ste 110, Little Rock, AR 72201 Phone: 501-672-5341 |