Family Psychological Center

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

00-12P Issued in AR

Legal business name

FAMILY PSYCHOLOGICAL CENTER

Practice address

623 N Walnut St
Harrison, AR 72601-3617

Phone

(870) 743-6225

Fax

(870) 743-6006

NPI assigned

Oct 25, 2006

Last updated

Jan 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Charles Nichols, PSY.D.NPI 1215994876

Title

Director/Ceo

Phone

(870) 743-6225

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Charles Nichols, PSYD

  • Clinical Psychologist
  • Harrison, AR
  • NPI 1215994876
  Medicare reassignment NPD Authorized official
• Kaleb Pratt, PSY.D.

  • Clinical Psychologist
  • Johnson City, TN
  • NPI 1760039929
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294012800000",
    "number": "1033293733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 N WALNUT ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013617",
            "telephone_number": "870-743-6225",
            "fax_number": "870-743-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 N WALNUT ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013617",
            "telephone_number": "870-743-6225",
            "fax_number": "870-743-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PSYCHOLOGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-01-03",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "870-743-6225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "00-12P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "5C757",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148984744",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milinda Evans, QBHP
• Gunner Evenson, QBHP
• Diana Michelle Everly
• Kelli S Faddis
• Family Doctors Clinic PA
• Shannon Farabee, MHPP
• Misty Dawn Farmer, MHPP
• Deborah Farrell, LPC
• Fayetteville Vamc
• Jennifer H Feighert, RNMHP

• Clinical Psychologist in Harrison, AR
• Providers in Harrison, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.