Alyssa Shaw, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P2504006 Issued in AR

Practice address

3623 Johnson Mill Blvd
Suite 103
Springdale, AR 72762-6412

Phone

(479) 435-4207

Fax

(479) 935-3180

NPI assigned

Jul 23, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eason Counseling and Associates, LLC

  • Clinical Social Worker
  • Springdale, AR
  • NPI 1861834368
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1003489279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9541",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727030026",
            "telephone_number": "479-435-4207",
            "fax_number": "479-935-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 JOHNSON MILL BLVD",
            "address_2": "SUITE 103",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626412",
            "telephone_number": "479-435-4207",
            "fax_number": "479-935-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALYSSA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2504006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272165795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kasilynn Alese Shaddy
• Sarah Shaddy
• Carol Lynn Shafer, RN
• Alexandria Nicole Shannon
• Aneet K Sharma, MD, DDS
• Calista Edith Shaw, MHPP
• Benjamin Shearer
• Craig Anthony Sheedy, M.D.
• Anne Renae Sheetz
• Iftakhar Ahmad Sheikh, PA-C

• Mental Health Counselor in Springdale, AR
• Providers in Springdale, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.