Shealtiel Blu Kuykendall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6690-C Issued in AR

Practice address

3708 Amberwood St.
Springdale, AR 72762

Phone

(479) 633-4049

NPI assigned

Apr 12, 2016

Last updated

Sep 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stevi Blu Kuykendall Professional name

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nwa Christian Counseling Group, Inc. Dba Brookway CounselingGroup PAC ID 8325394604, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nwa Christian Counseling Group, Inc. Dba Brookway Counseling

  dba Brookway Counseling

  • Clinical Social Worker
  • Springdale, AR
  • NPI 1881197697
  Medicare reassignment Care Compare group NPD
• Stevi Kuykendall LCSW LLC

  • Clinical Social Worker
  • Springdale, AR
  • NPI 1114862208
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1073977476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 W POPLAR ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564245",
            "telephone_number": "479-636-9235",
            "fax_number": "479-631-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 AMBERWOOD ST.",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "72762",
            "telephone_number": "479-633-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUYKENDALL",
        "first_name": "SHEALTIEL",
        "middle_name": "BLU",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "6690-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6690-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEVI",
            "last_name": "KUYKENDALL",
            "middle_name": "BLU",
            "credential": "LMSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Moriah Elaine Kramer, M.D.
• Walt Kramer
• Schuyler Ronan Kraus, DACM, DIPL. OM, L.AC
• Megan Michelle Kumpe, PNP
• Sasha Laine Kutz, APRN, NP-C
• Kyle W. Harris DDS. PLLC
• Jessica Lagrone, CD, CCE, MAT
• Ashley D Lahue
• Landry Laird, PT, DPT
• Lakeside Surgery Center, LLC

• Clinical Social Worker in Springdale, AR
• Providers in Springdale, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.