Active NPI
Mary Jane Korson, LICENSED PROFESSIONA
- Professional Counselor
- Mountain Home, AR
National Provider Identifier
1164577078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P0608047
- Practice address
- 312 Bomber Blvd
Mountain Home, AR 72653 - Phone
- (870) 425-3840
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P0608047 | AR | Primary |
Addresses
Primary practice location
312 Bomber Blvd
Mountain Home, AR 72653
Mailing address
3978 County Road 37
Clarkridge, AR 72623
Phone (870) 425-3681
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0608047 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164577078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3978 COUNTY ROAD 37",
"city": "CLARKRIDGE",
"state": "AR",
"postal_code": "72623",
"telephone_number": "870-425-3681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 BOMBER BLVD",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "72653",
"telephone_number": "870-425-3840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORSON",
"first_name": "MARY",
"middle_name": "JANE",
"name_prefix": "Ms.",
"credential": "LICENSED PROFESSIONA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P0608047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.