Individual provider Active NPI

Ada Floyd, LAC

  • Mental Health Counselor
  • Fort Smith, AR
National Provider Identifier
1114203874
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A1505069 Issued in AR
Practice address
7701 S Zero St
Fort Smith, AR 72903-6644
Phone
(479) 420-0913
Fax
(479) 784-1471
NPI assigned
Oct 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A1505069 AR Primary

Addresses

Primary practice location

7701 S Zero St
Fort Smith, AR 72903-6644

Mailing address

PO Box 11495
Fort Smith, AR 72917-1495
Phone (479) 420-0913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 27, 2024 through Jun 27, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A1505069ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bost, Inc. PastSince Nov 28, 2018 Accepting new patients
The Whitson Group, LLC Mental Health PastSince Jan 29, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1114203874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11495",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171495",
            "telephone_number": "479-420-0913",
            "fax_number": "479-784-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 S ZERO ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036644",
            "telephone_number": "479-420-0913",
            "fax_number": "479-784-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "ADA",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1505069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.