Individual provider Active NPI

Jillian Deniese Stewart, LPC

  • Mental Health Counselor
  • Little Rock, AR
National Provider Identifier
1013043793
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P1101001 Issued in AR
Practice address
11700 Kanis Rd Ste 2
Little Rock, AR 72211-3794
Phone
(501) 221-1941
Fax
(501) 843-9656
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P1101001 AR Primary

Addresses

Primary practice location

11700 Kanis Rd Ste 2
Little Rock, AR 72211-3794

Mailing address

11700 Kanis Rd Ste 2
Little Rock, AR 72211-3794
Phone (501) 221-1941

Other names 1

  • Jillian Deniese Fennessee Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231211000279 AR Practitioner - Mental Health Counselor 7416306964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspiration Day Treatment, Inc.Group PAC ID 5698801272, 8 clinicians

Practice addresses (Care Compare)

11700 Kanis Rd
Suite 2
Little Rock, AR 72211-3794
Phone (501) 221-1941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P1101001ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inspiration Day Treatment, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

11700 Kanis Rd
Ste 2
Little Rock, AR 72211
Phone (501) 221-1941

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1013043793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 KANIS RD STE 2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113794",
            "telephone_number": "501-221-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 KANIS RD STE 2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113794",
            "telephone_number": "501-221-1941",
            "fax_number": "501-843-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JILLIAN",
        "middle_name": "DENIESE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1101001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "FENNESSEE",
            "middle_name": "DENIESE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.