Jennifer Conyac

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A2212003 Issued in AR

Practice address

3700 Medical Center Pkwy
Bentonville, AR 72712-3222

Phone

(918) 800-1574

NPI assigned

Jan 25, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1033825815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 TARTAGLIA AVE",
            "city": "TONTITOWN",
            "state": "AR",
            "postal_code": "727623073",
            "telephone_number": "417-699-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 MEDICAL CENTER PKWY",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123222",
            "telephone_number": "918-800-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONYAC",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2212003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dane Connell
• Sonja R Conner
• Dana Scott Conrad
• Dianne Lee Conroy, LPC
• Allisyn Converse
• Margaret G Cook
• Charles Coon, DDS
• William Coones
• Aritney B Cooper
• Lela Cooper, RRT

• Mental Health Counselor in Bentonville, AR
• Providers in Bentonville, 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 Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.