Individual provider Active NPI

Sharon A Odom, LCSW

  • Clinical Social Worker
  • Bentonville, AR
National Provider Identifier
1033196324
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6742-C Issued in AR
Practice address
2508 SE 20TH St
Bentonville, AR 72712-4008
Phone
(479) 273-9088
Fax
(479) 750-4843
NPI assigned
Dec 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34002972A IN
Clinical Social Worker 1041C0700X 6742-C AR Primary

Addresses

Primary practice location

2508 SE 20TH St
Bentonville, AR 72712-4008

Mailing address

2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020

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
I20130225000188 AR Practitioner - Clinical Social Worker 0345313425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

102 Country Club Pkwy
Suite a
Maumelle, AR 72113-7048
Phone (501) 628-9066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34002972AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Telepsychiatry - Arkansas CurrentSince May 10, 2022 Accepting new patients
Thrive Counseling LLC CurrentSince Apr 19, 2021 Accepting new patients
Lead, Teach, Mentor LLC Past Accepting new patients

Locations

102 Country Club Pkwy
Ste A
Maumelle, AR 72113
Phone (501) 628-9066

4704 W Commercial Dr
Ste A
North Little Rock, AR 72116
Phone (501) 397-1015

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 3

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1033196324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 SE 20TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124008",
            "telephone_number": "479-273-9088",
            "fax_number": "479-750-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "SHARON",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002972A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6742-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.