Brenton Paul Ezell, LCSW – Clinical Social Worker

Key facts

NPI: 1003225301
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
Practice address: 111 S 3Rd Ave
Piggott, AR 72454-2634
Phone: (870) 598-0306
Fax: (870) 598-0328
NPI assigned: Aug 12, 2014
Sex: Male
Sole proprietor: No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Families, Inc of Arkansas Mental Health Clinic/Center (Including Community Mental Health Center) · Jonesboro, AR · NPI 1770535569

Medicare reassignment Care Compare group NPD AR
Families, Inc. of Arkansas Mental Health Clinic/Center (Including Community Mental Health Center) · Osceola, AR · NPI 1366532103

NPD

Medicare Care Compare profile

Specialty: Clinical Social Worker
Education: Other, 2021
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Families, Inc of Arkansas (44 clinicians)

Practice addresses (Care Compare)

111 S 3Rd Ave
Piggott, AR 72454-2634
Phone (870) 598-0306

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AR
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240410002814	AR	Practitioner - Clinical Social Worker	6406294321	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Families, Inc of Arkansas		Current since Feb 24, 2024	Accepting new patients
Families, Inc. of Arkansas		Current since Feb 24, 2024	Accepting new patients

Locations

1815 Pleasant Grove Rd
Jonesboro, AR 72405
Phone (870) 833-6886

111 S 3rd Ave
Piggott, AR 72454
Phone (870) 598-0306

1425 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-5303

Specialties & licenses

Specialty (taxonomy)	Code	State	Primary
Case Manager/Care Coordinator	171M00000X
Case Manager/Care Coordinator	171M00000X	AR
Clinical Social Worker	1041C0700X		Yes

Addresses

Primary practice location

111 S 3Rd Ave
Piggott, AR 72454-2634

Mailing address

1815 Pleasant Grove Rd
Jonesboro, AR 72405-7870
Phone (870) 933-6886

Other identifiers

Identifier	Type	State	Issuer
203630795	Medicaid	AR

Other names

Brent Ezell Other name

Other providers in Piggott, AR

All providers in Piggott, AR · Clinical Social Worker in Arkansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.