John Anthony McCollum, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2506006 Issued in AR

Practice address

5003 Old Greenwood Rd Ste B
Fort Smith, AR 72903-6924

Phone

(479) 280-9980

Fax

(501) 421-2336

NPI assigned

Aug 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Friendship Community Care Inc.

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Russellville, AR
  • NPI 1528144318
  NPD (past)

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1033994595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728112109",
            "telephone_number": "479-967-2322",
            "fax_number": "479-967-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 OLD GREENWOOD RD STE B",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036924",
            "telephone_number": "479-280-9980",
            "fax_number": "501-421-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A2308023",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2506006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey McClune, MHPP
• Matthew Alan McClure, LPC
• Ryan McClure, MHPP
• Spencer McClure, MD
• Peter McCollough, QBHP
• Joshua McCollum
• Derek McCool, DO
• Melea McCormick, APRN
• Amaris McCoy
• Casey Lauren McCoy, APRN

• Professional Counselor in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.