Individual provider Active NPI

Tracy Lynn Vonallmen, LCSW

  • Clinical Social Worker
  • Jonesboro, AR
National Provider Identifier
1093904716
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2603-C Issued in AR
Practice address
1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone
(870) 933-6886
Fax
(870) 933-9395
NPI assigned
Oct 18, 2007
Last updated
May 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2603-C AR Primary

Addresses

Primary practice location

1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
5V808OtherBCBS
172914795MedicaidAR

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
I20111026000184 AR Practitioner - Clinical Social Worker 4981877644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Roadmaps Counseling and Mediation, Inc.Group PAC ID 1355683178, 3 clinicians

Practice addresses (Care Compare)

130 Bomber Blvd
Mountain Home, AR 72653-4626
Phone (870) 424-0570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2603-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Families, Inc of Arkansas CurrentSince Sep 29, 2011 Accepting new patients

Locations

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

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

Organizations & group practices 2

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": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1093904716",
    "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": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONALLMEN",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2603-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5V808",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172914795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.