Individual provider Active NPI

Kendyl Dawn Hovis, MS, LPC-S

  • Professional Counselor
  • Bentonville, AR
National Provider Identifier
1033458716
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P1804049 Issued in AR
Practice address
2700 SE Otis Corley Dr Ste 14
Bentonville, AR 72712-4184
Phone
(479) 895-1313
Fax
(479) 397-4813
NPI assigned
Jan 31, 2013
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P1804049 AR Primary

Addresses

Primary practice location

2700 SE Otis Corley Dr Ste 14
Bentonville, AR 72712-4184

Mailing address

2700 SE Otis Corley Dr Ste 14
Bentonville, AR 72712-4184
Phone (479) 895-1313

Other identifiers 2

IdentifierTypeStateIssuer
231726719MedicaidAR
490082119MedicaidMO

Other names 1

  • Kendyl Dawn Tinsley 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
I20240221004469 AR Practitioner - Mental Health Counselor 6901240530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Chenal Family Therapy, PLC CurrentSince Feb 8, 2024 Accepting new patients
Transitions Counseling Clinic PLC Professional PastSince Apr 9, 2023 Accepting new patients

Locations

304 W Collin Raye Dr
Ste 103A
De Queen, AR 71832
Phone (870) 200-9294

10311 W Markham St
Little Rock, AR 72205
Phone (501) 681-3300

5507 W Walsh Ln
Ste 201
Rogers, AR 72758
Phone (280) 647-9367

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1033458716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SE OTIS CORLEY DR STE 14",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124184",
            "telephone_number": "479-895-1313",
            "fax_number": "479-397-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SE OTIS CORLEY DR STE 14",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124184",
            "telephone_number": "479-895-1313",
            "fax_number": "479-397-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOVIS",
        "first_name": "KENDYL",
        "middle_name": "DAWN",
        "credential": "MS, LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1804049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231726719",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490082119",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDYL",
            "last_name": "TINSLEY",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.