Paul T Hickerson, PHD, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P1408057 Issued in AR

Practice address

106 E Main
Russellville, AR 72801-5128

Phone

(479) 692-1208

Fax

(866) 538-2772

NPI assigned

May 10, 2011

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Western Arkansas Counseling and Guidance Center, IncGroup PAC ID 1355326174, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Western Arkansas Counseling & Guidance Center, Inc

  • Community/Behavioral Health Agency
  • Fort Smith, AR
  • NPI 1326040692
  Medicare reassignment Care Compare group NPD
• Restored Life Services of Arkansas Inc

  • Addiction (Substance Use Disorder) Counselor
  • Russellville, AR
  • NPI 1558727024
  Medicare reassignment NPD
• Invocation LLC

  • Mental Health Counselor
  • Russellville, AR
  • NPI 1336670793
  NPD (past) Authorized official
• The Guidance Center - Van Buren Clinic

  • Community/Behavioral Health Agency
  • Van Buren, AR
  • NPI 1376718775
  NPD
• The Guidance Center - Whole Health

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1730787037

  Mental Health

  NPD
• Perspectives Behavioral Health Management, LLC

  • Mental Health Counselor
  • Fort Smith, AR
  • NPI 1124273420
  NPD (past)
• Perspectives Behavioral Health Management, LLC

  • Psychiatry Physician
  • Barling, AR
  • NPI 1588709646
  NPD (past)

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1134411036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1251",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727309998",
            "telephone_number": "479-692-1208",
            "fax_number": "866-538-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E MAIN",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728015128",
            "telephone_number": "479-692-1208",
            "fax_number": "866-538-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "PAUL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1408057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Henry, MD
• Desiree D Herman, NURSE PRACTITIONER
• Jasmin Hernandez
• Shannon Renee Herring, SLP
• J'Lun Dawan Herron, LAC
• Andrew James Hickman, OD
• Phillip M Higdon, MS LADAC CCS
• Lauren Higgins
• Ryan Higgs
• Lauren Nicole Hightower, APRN

• Mental Health Counselor in Russellville, AR
• Providers in Russellville, 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 Nov 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.