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Kyle Clark Anderson

Individual provider Active NPI Professional Counselor · Batesville, AR

NPI 1114063765 · NPPES record last updated Jun 10, 2019

Key facts

NPI
1114063765
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
P1810134 (AR)
Practice address
500 E Main St
Suite 310
Batesville, AR 72501-4660
Phone
(870) 569-4890
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A1608108ARMDCounselor
P1810134ARMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
United Methodist Behavioral Health System, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A1608108 AR
Case Manager/Care Coordinator 171M00000X AR
Professional Counselor 101YP2500X P1810134 AR Yes

Addresses

Primary practice location

500 E Main St
Suite 310
Batesville, AR 72501-4660

Mailing address

1600 Aldersgate Rd
Suite 200
Little Rock, AR 72205-6676
Phone (501) 661-0720

Other providers in Batesville, AR

All providers in Batesville, AR · Professional Counselor in Arkansas

Sources for this page

Verify at the official NPI Registry.