| Therapy Assessment Center, Llc | |
|
317 Oak St Ste 3 Conway AR 72032 | |
| (501) 291-3091 | |
| (501) 588-0484 |
| Full Name | Therapy Assessment Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 317 Oak St Ste 3, Conway, Arkansas |
| Authorized Official Name and Position | Samantha Sewell Short (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 5012913091 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Assessment Center, Llc 317 Oak St Ste 3 Conway AR 72032-5679 Ph: (501) 291-3091 | Therapy Assessment Center, Llc 317 Oak St Ste 3 Conway AR 72032 Ph: (501) 291-3091 |
| NPI Number | 1093184210 |
|---|---|
| Provider Enumeration Date | 09/17/2015 |
| Last Update Date | 09/06/2019 |
| Medicare PECOS PAC ID | 0941538557 |
|---|---|
| Medicare Enrollment ID | O20190821000368 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093184210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
| Provider Name | Samantha Short |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144465139 PECOS PAC ID: 1850629460 Enrollment ID: I20191211000648 |
| Provider Name | Kimberly Ann Callaway Gentry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073137253 PECOS PAC ID: 3577940568 Enrollment ID: I20220512001713 |
| Provider Name | Jacob A Defee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063750404 PECOS PAC ID: 8729431259 Enrollment ID: I20240131001972 |
Dayspring Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Bruce St, Conway, AR 72034 Phone: 501-336-0100 Fax: 501-336-0115 | |
An Embraced Life Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1422 Caldwell St, Suite H, Conway, AR 72034 Phone: 501-499-9231 Fax: 501-904-4373 | |
Catalyst Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 930 Wingate St Ste E2, Conway, AR 72034 Phone: 501-500-4114 Fax: 501-764-4555 | |
Community Service Inc. - Conway Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 818 N Creek Dr, Conway, AR 72032 Phone: 501-327-9788 Fax: 501-327-9843 | |
Wellnite Medical Group Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2395 Prince St, Conway, AR 72034 Phone: 341-888-7637 | |
Lighted Path Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1124 Oak St, Suite 250, Conway, AR 72032 Phone: 804-592-1205 Fax: 866-388-8128 |