| Vibrant Therapy Collective, Llc | |
|
262 Southwest Dr Jonesboro AR 72401-5829 | |
| (870) 938-0052 | |
| Not Available |
| Full Name | Vibrant Therapy Collective, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 262 Southwest Dr, Jonesboro, Arkansas |
| Authorized Official Name and Position | Stephanie Sweat (OWNER) |
| Authorized Official Contact | 8706799972 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vibrant Therapy Collective, Llc 262 Southwest Dr Jonesboro AR 72401-5829 Ph: (870) 679-9972 | Vibrant Therapy Collective, Llc 262 Southwest Dr Jonesboro AR 72401-5829 Ph: (870) 938-0052 |
| NPI Number | 1457010498 |
|---|---|
| Provider Enumeration Date | 12/16/2021 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Medicare PECOS PAC ID | 2668866450 |
|---|---|
| Medicare Enrollment ID | O20220221001054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457010498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie Tamarra Sweat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487006748 PECOS PAC ID: 0244631232 Enrollment ID: I20210629000117 |
| Provider Name | Stephanie Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063829745 PECOS PAC ID: 2567846124 Enrollment ID: I20220831000168 |
| Provider Name | Shaquata Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831431733 PECOS PAC ID: 2961944137 Enrollment ID: I20240604002048 |
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