Individual provider Active NPI

Andrea Stiles, LCSW

  • Clinical Social Worker
  • Jacksonville, AR
National Provider Identifier
1073529491
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1931-C Issued in AR
Practice address
2126 N 1St St Ste F
Jacksonville, AR 72076-2868
Phone
(501) 982-5000
Fax
(501) 982-5007
NPI assigned
Jul 31, 2006
Last updated
May 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X 1931-C AR Primary

Addresses

Primary practice location

2126 N 1St St Ste F
Jacksonville, AR 72076-2868

Mailing address

1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone (870) 933-6886

Other identifiers 4

IdentifierTypeStateIssuer
5Y348OtherARBLUECROSS PROVIDER NUMBER
5Y348OtherARBCBS
172634795MedicaidAR
5A348OtherARBCBS

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
I20050628001355 AR Practitioner - Clinical Social Worker 9234175480 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Within Counseling Group LLCGroup PAC ID 0446684971, 2 clinicians

Practice addresses (Care Compare)

106 N Pecan St
Beebe, AR 72012-2524
Phone (501) 232-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1931-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Within Counseling Group, LLC CurrentSince Mar 11, 2021 Accepting new patients
Families, Inc of Arkansas CurrentSince Jun 10, 2002 Accepting new patients
Families, Inc. of Arkansas CurrentSince Jun 10, 2002 Accepting new patients

Locations

106 N Pecan St
Beebe, AR 72012
Phone (501) 232-2600

1815 Pleasant Grove Rd
Jonesboro, AR 72405
Phone (870) 833-6886

2126 N 1st St
Ste F
Little Rock AFB, AR 72076
Phone (501) 982-5000

1425 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-5303

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1073529491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 N 1ST ST STE F",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720762868",
            "telephone_number": "501-982-5000",
            "fax_number": "501-982-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1931-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS PROVIDER NUMBER",
            "identifier": "5Y348",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5Y348",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172634795",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5A348",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AR

Sources for this page

Verify at the official NPI Registry.