Nwa Premier Therapy

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NWA PREMIER THERAPY

Practice address

5305 W Village Pkwy
Suite 8
Rogers, AR 72758

Phone

(479) 372-7446

NPI assigned

Jan 29, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Victoria Lynn Sullivan, LPC

Title

Owner

Phone

(479) 372-7446

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1043774516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 W VILLAGE PKWY",
            "address_2": "SUITE 8",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-372-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 W VILLAGE PKWY",
            "address_2": "SUITE 8",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-372-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NWA PREMIER THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-372-7446",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P0304018",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mandi Nussbaum, APRN
• Nwa Hearing LLC
• Nwa MD Consulting PLLC
• Nwa Mobility, LLC
• Nwa Premier Counseling
• Nwa Tongue Tie Center, PLLC
• Cecelia Rose O'Keefe, PHARMD
• Odyssey Therapy Nwa, LLC
• Callie Ogden
• Gaurav Ohol, PHARM D

• Mental Health Clinic/Center (Including Community Mental Health Center) in Rogers, AR
• Providers in Rogers, AR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.