Individual provider Active NPI

Chris Porter, RECOVERY ASSISTANT

  • Mental Health Counselor
  • Malvern, AR
National Provider Identifier
1174845242
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1003 Schneider Dr
Malvern, AR 72104-4811
Phone
(501) 653-7604
Fax
(501) 290-2170
NPI assigned
Feb 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X AR
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1003 Schneider Dr
Malvern, AR 72104-4811

Mailing address

PO Box 451
Malvern, AR 72104-0451
Phone (501) 732-6511

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240722001291 AR Practitioner - Mental Health Counselor 7719423177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope and Wellness PLLCGroup PAC ID 3678945201, 4 clinicians

Practice addresses (Care Compare)

1003 Schneider Dr
Malvern, AR 72104-4811
Phone (501) 653-7604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hope and Wellness PLLC CurrentSince Aug 26, 2024 Accepting new patients

Locations

1003 Schneider Dr
Malvern, AR 72104
Phone (501) 337-5678

Organizations & group practices 1

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": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1174845242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721040451",
            "telephone_number": "501-732-6511",
            "fax_number": "501-290-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 SCHNEIDER DR",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044811",
            "telephone_number": "501-653-7604",
            "fax_number": "501-290-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "CHRIS",
        "credential": "RECOVERY ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.