Individual provider Active NPI

Shanece Herron

  • Professional Counselor
  • Little Rock, AR
National Provider Identifier
1063898989
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P2209002 Issued in AR
Practice address
1 Lile CT Ste 200
Little Rock, AR 72205-6240
Phone
(501) 663-1837
Fax
(501) 663-1839
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X P2209002 AR Primary

Addresses

Primary practice location

1 Lile CT Ste 200
Little Rock, AR 72205-6240

Mailing address

1719 Merrill Dr
Little Rock, AR 72212-4009
Phone (501) 663-2199

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
I20250113002814 AR Practitioner - Mental Health Counselor 3375071756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P2209002ARMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Real Development Corporation CurrentSince Jan 7, 2025 Accepting new patients
Life Strategies Counseling, Inc. PastSince Nov 1, 2019 Accepting new patients
New Beginings Behavioral Health Past Accepting new patients

Locations

1 Lile Ct
Ste 200
Little Rock, AR 72205
Phone (501) 224-5500

1310 W Main St
Ste 201
Russellville, AR 72801
Phone (479) 968-2001

1310 W Main St
Ste 101
Russellville, AR 72801
Phone (479) 964-2011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1063898989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 MERRILL DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124009",
            "telephone_number": "501-663-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LILE CT STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056240",
            "telephone_number": "501-663-1837",
            "fax_number": "501-663-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "SHANECE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2209002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.