Kaitlin Stober, CCTP, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P2009082 Issued in AR

Practice address

1900 Stillwater Dr
Jonesboro, AR 72404-9119

Phone

(870) 932-3600

NPI assigned

Jan 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Sage Counseling LLC

  • Mental Health Counselor
  • Forrest City, AR
  • NPI 1720741168
  NPD Authorized official

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1083112718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 VIRGINIA CIR",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352531",
            "telephone_number": "870-635-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 STILLWATER DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049119",
            "telephone_number": "870-932-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOBER",
        "first_name": "KAITLIN",
        "name_prefix": "Mrs.",
        "credential": "CCTP, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-29",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2009082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denita Scott Stillwell, CCC-SLP
• Sheila Stinson, M.D.
• Gerald S Stipanuk, MD
• Sierra Stipp, LCSW
• Darci A Stobaugh
• Donovan Ritchie Stockdale, M.D.
• Dana Michelle Stokes
• Pharane Juanita Stokes
• Phillip Wayne Stokes Jr., FNP-C
• Sabrina L Stokes

• Mental Health Counselor in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.