Star Harbottle, LAC
Individual provider Active NPI Mental Health Counselor · Fort Smith, AR
NPI 1003371709 · NPPES record last updated Feb 24, 2020
Key facts
- NPI
- 1003371709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- A2002034 (AR)
- Practice address
- 3111 S 70TH St
Fort Smith, AR 72903-5017 - Phone
- (479) 452-6650
- Fax
- (479) 452-5847
- NPI assigned
- Feb 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A2002034 | AR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perspectives Behavioral Health Management, LLC | Case Manager/Care Coordinator | Past |
Accepting new patients |
| Perspectives Behavioral Health Management, LLC | Mental Health | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Mental Health Counselor | 101YM0800X | A2002034 | AR | Yes |
Addresses
Primary practice location
3111 S 70TH St
Fort Smith, AR 72903-5017
Mailing address
PO Box 11818
Fort Smith, AR 72917-1818
Phone (479) 452-6650
Other providers in Fort Smith, AR
- Olivia Hanson
- Mohab Haraka
- Stuart Dean Haraway
- Kerri Harber
- Harbor House Incorporated of Fort Smith Arkansas
- Allison Hardin
- Jessica Hare
- Devi Hari
- Adrianne Harless
- Megan Harmon
All providers in Fort Smith, AR · Mental Health Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.