| The Logan Centers, Inc. | |
|
1217 W Parker Rd Ste D Jonesboro AR 72404-8497 | |
| (870) 520-5014 | |
| (870) 520-5015 |
| Full Name | The Logan Centers, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1217 W Parker Rd Ste D, Jonesboro, Arkansas |
| Authorized Official Name and Position | Shannon Sherman (CEO) |
| Authorized Official Contact | 8705205014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Logan Centers, Inc. Po Box 11064 Fayetteville AR 72703-1001 Ph: (870) 520-5014 | The Logan Centers, Inc. 1217 W Parker Rd Ste D Jonesboro AR 72404-8497 Ph: (870) 520-5014 |
| NPI Number | 1932119187 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 01/05/2024 |
| Certification Date | 01/05/2024 |
| Medicare PECOS PAC ID | 0446208813 |
|---|---|
| Medicare Enrollment ID | O20050112000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932119187 | NPI | - | NPPES |
| 155496726 | Medicaid | AR | |
| 171065526 | Medicaid | AR | |
| 229295526 | Medicaid | AR | |
| 161615526 | Medicaid | AR | |
| 266784526 | Medicaid | AR |
| Provider Name | Cori A Dyson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730304874 PECOS PAC ID: 8325147531 Enrollment ID: I20070628000049 |
| Provider Name | Todd M Clements |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275603581 PECOS PAC ID: 2264757681 Enrollment ID: I20150206000094 |
| Provider Name | Raena R Tinnon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184828303 PECOS PAC ID: 1355738816 Enrollment ID: I20220502000858 |
| Provider Name | Jane N Pitcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063791598 PECOS PAC ID: 1052708468 Enrollment ID: I20220503000702 |
| Provider Name | Linda Michelle Rhodes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811022833 PECOS PAC ID: 5294176285 Enrollment ID: I20240508001239 |
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