Tessa Renee Vanderhorn, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A2308025 Issued in AR

Practice address

128 Southwinds Rd
Farmington, AR 72730-8678

Phone

(479) 222-1156

NPI assigned

Sep 6, 2023

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Soul Spark Counseling, LLC

  • Mental Health Counselor
  • Farmington, AR
  • NPI 1407632334
  NPD Authorized official

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1174309017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "PRAIRIE GROVE",
            "state": "AR",
            "postal_code": "727531121",
            "telephone_number": "509-306-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 SOUTHWINDS RD",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308678",
            "telephone_number": "479-222-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHORN",
        "first_name": "TESSA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2308025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Think Wellness LLC
• Tiffani a, Long
• Kaylin E Ulbrich, LCSW
• Upper Cervical Clinic of Northwest Arkansas
• Sarah Van Camp, OTR/L
• Vetcentric Mental Health Services
• Taylor Vongphakdy, COTA/L
• Walmart Inc.
• Ronda Ward
• Washington Regional Medical System

• Mental Health Counselor in Farmington, AR
• Providers in Farmington, 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 Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.