Individual provider Active NPI

Cale E McGillvray, LPC, LMFT

  • Professional Counselor
  • Bald Knob, AR
National Provider Identifier
1124455225
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P1611178 Issued in AR
Practice address
178 Highway 167 N
Bald Knob, AR 72010-4058
Phone
(501) 724-6207
Fax
(501) 724-3305
NPI assigned
Oct 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X M1612010 AR
Professional Counselor 101YP2500X P1611178 AR Primary

Addresses

Primary practice location

178 Highway 167 N
Bald Knob, AR 72010-4058

Mailing address

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

Other practice location 1

1507 E. Race St.
Searcy, AR 72143-4661
Phone (501) 305-2359

Other identifiers 1

IdentifierTypeStateIssuer
227623719MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: No
  • 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
I20240228001811 AR Practitioner - Mental Health Counselor 3577912864 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P1611178ARMDProfessional Counselor
M1612010ARMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arcare Current Accepting new patients
Arcare CurrentSince Jun 3, 2024 Accepting new patients
Arcare CurrentSince Jun 3, 2024 Accepting new patients
Families, Inc of Arkansas Mental Health CurrentSince Jan 23, 2024 Accepting new patients
Families, Inc of Arkansas CurrentSince Jan 23, 2024 Accepting new patients

Locations

623 N 9th St
#40
Augusta, AR 72006

178 Highway 167 N
Bald Knob, AR 72010
Phone (501) 724-6207

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

2126 N 1st St
Ste F
Little Rock AFB, AR 72076
Phone (501) 982-5000

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

Organizations & group practices 5

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": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1124455225",
    "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": "178 HIGHWAY 167 N",
            "city": "BALD KNOB",
            "state": "AR",
            "postal_code": "720104058",
            "telephone_number": "501-724-6207",
            "fax_number": "501-724-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1507 E. Race St.",
            "address_purpose": "LOCATION",
            "city": "Searcy",
            "state": "AR",
            "postal_code": "721434661",
            "country_code": "US",
            "telephone_number": "501-305-2359",
            "fax_number": "501-305-2348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGILLVRAY",
        "first_name": "CALE",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LPC, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-03",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AR",
            "license": "M1612010",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1611178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227623719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bald Knob, AR

Sources for this page

Verify at the official NPI Registry.