| Pure Balance Of Nwa Pllc | |
|
3608 W Southern Hills Blvd Rogers AR 72758-8013 | |
| (479) 633-7052 | |
| Not Available |
| Full Name | Pure Balance Of Nwa Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3608 W Southern Hills Blvd, Rogers, Arkansas |
| Authorized Official Name and Position | Jacob Boydstun (OWNER) |
| Authorized Official Contact | 4327705923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Balance Of Nwa Pllc 3608 W Southern Hills Blvd Rogers AR 72758-8013 Ph: (479) 633-7052 | Pure Balance Of Nwa Pllc 3608 W Southern Hills Blvd Rogers AR 72758-8013 Ph: (479) 633-7052 |
| NPI Number | 1073359931 |
|---|---|
| Provider Enumeration Date | 07/01/2024 |
| Last Update Date | 08/05/2024 |
| Certification Date | 07/23/2024 |
| Medicare PECOS PAC ID | 6901344928 |
|---|---|
| Medicare Enrollment ID | O20240821001375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073359931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Chelsie M Harper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598178832 PECOS PAC ID: 7618251356 Enrollment ID: I20170224001983 |
| Provider Name | Jacob M Boydstun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568805299 PECOS PAC ID: 1355668310 Enrollment ID: I20170501000863 |
| Provider Name | Kelly R. Mccarty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821619370 PECOS PAC ID: 7810377991 Enrollment ID: I20220707000453 |
| Provider Name | Ashlea Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396464475 PECOS PAC ID: 7214313691 Enrollment ID: I20221008000444 |
| Provider Name | Ashley Anne Wardlaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598144594 PECOS PAC ID: 0547616690 Enrollment ID: I20231025001867 |
| Provider Name | Susanne Carter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407250525 PECOS PAC ID: 0244688091 Enrollment ID: I20240216003338 |
| Provider Name | Morgan Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841045234 PECOS PAC ID: 7012458722 Enrollment ID: I20240923000130 |
| Provider Name | Vanessa Nerey Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710706692 PECOS PAC ID: 8022543412 Enrollment ID: I20241121003552 |
Neurobess Pa Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1000 S 52nd St, Rogers, AR 72758 Phone: 479-271-9607 Fax: 479-271-2133 | |
Pathways Counseling Nwa Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2106 S 54th St Ste 3, Rogers, AR 72758 Phone: 479-295-7800 | |
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Freeman-burchfield And Welles Institute Of Cognitive Behavioral Therap Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5210 W Village Pkwy, Rogers, AR 72758 Phone: 479-372-7446 Fax: 479-802-4765 | |