| Therapeutic Family Services | |
|
829 Halbert St Malvern AR 72104-2607 | |
| (501) 332-4400 | |
| (501) 332-4403 |
| Full Name | Therapeutic Family Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 829 Halbert St, Malvern, Arkansas |
| Authorized Official Name and Position | Abby Kyle (CEO) |
| Authorized Official Contact | 5013324400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Family Services 829 Halbert St Malvern AR 72104-2607 Ph: (501) 332-4400 | Therapeutic Family Services 829 Halbert St Malvern AR 72104-2607 Ph: (501) 332-4400 |
| NPI Number | 1639180805 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/09/2024 |
| Medicare PECOS PAC ID | 3971594052 |
|---|---|
| Medicare Enrollment ID | O20061012000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639180805 | NPI | - | NPPES |
| 181394526 | Medicaid | AR | |
| 152687726 | Medicaid | AR | |
| 152689726 | Medicaid | AR | |
| 152688726 | Medicaid | AR | |
| 179969526 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Arkansas) | Primary |
| Provider Name | Robert Emmett Farrell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669494092 PECOS PAC ID: 7416843842 Enrollment ID: I20040224000416 |
| Provider Name | Rhonda M Mattox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154412815 PECOS PAC ID: 4385646355 Enrollment ID: I20070203000052 |
| Provider Name | Sharlyn Ann Woody |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962475517 PECOS PAC ID: 8325220874 Enrollment ID: I20110304000655 |
| Provider Name | Penny Stokes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366702102 PECOS PAC ID: 4587982780 Enrollment ID: I20150420001885 |
| Provider Name | Bethany S Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063600997 PECOS PAC ID: 1052682036 Enrollment ID: I20181015002282 |
| Provider Name | Kristina M Dodson Dupree |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336432236 PECOS PAC ID: 7911234513 Enrollment ID: I20190805002565 |
| Provider Name | Holly J De Sambourg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811480320 PECOS PAC ID: 5991199580 Enrollment ID: I20220224001352 |
| Provider Name | Jeff Parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528536729 PECOS PAC ID: 2567824493 Enrollment ID: I20230809002871 |
| Provider Name | Sara Deane Thomas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639323389 PECOS PAC ID: 5597115204 Enrollment ID: I20231221000671 |
| Provider Name | Courtney Bacon-latina |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1922649532 PECOS PAC ID: 0840642492 Enrollment ID: I20240118003523 |
| Provider Name | Phillip Runyan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063685840 PECOS PAC ID: 0840635942 Enrollment ID: I20240228003227 |
| Provider Name | Cesar Beltran |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568773356 PECOS PAC ID: 3072055565 Enrollment ID: I20240612002094 |
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