Individual provider Active NPI

Alisha Diane Pickett, QBHP

  • Case Manager/Care Coordinator
  • Little Rock, AR
National Provider Identifier
1053937789
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
20400 Colonel Glenn Rd
Little Rock, AR 72210-5323
Phone
(501) 821-5500
NPI assigned
Jun 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

20400 Colonel Glenn Rd
Little Rock, AR 72210-5323

Mailing address

2401 Lakeview Rd Apt CC8
North Little Rock, AR 72116-9369
Phone (405) 414-8702

Other practice location 1

3621 N Kelley Ave Ste 100
Oklahoma City, OK 73111-4520
Phone (405) 524-5525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Home Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youthhome/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1053937789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 LAKEVIEW RD APT CC8",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721169369",
            "telephone_number": "405-414-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20400 COLONEL GLENN RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105323",
            "telephone_number": "501-821-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3621 N Kelley Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731114520",
            "country_code": "US",
            "telephone_number": "405-524-5525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "ALISHA",
        "middle_name": "DIANE",
        "name_prefix": "Miss",
        "credential": "QBHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.