Kenjarvis Cross, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

209 S Lockard St
Blytheville, AR 72315-2541

Phone

(870) 763-2139

NPI assigned

Apr 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arisa Health IncGroup PAC ID 2264853829, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Springdale, AR
  • NPI 1437750411

  Clinical

  Medicare reassignment Care Compare group NPD
• Majestic Counseling and Rehabilitation Services LLC

  • Clinical Social Worker
  • Jonesboro, AR
  • NPI 1043032410
  NPD Authorized official
• Arisa Health, Inc.

  • Community/Behavioral Health Agency
  • Jonesboro, AR
  • NPI 1306532767
  NPD

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1184078875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S LOCKARD ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152541",
            "telephone_number": "870-763-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 S LOCKARD ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152541",
            "telephone_number": "870-763-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "KENJARVIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "8109-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Danielle Cooper, CHILD CIS
• Lindsey Crafton, SLP
• Dana Renee Craig
• Hallie Crews
• Stanley Wilson Crisler
• Custom Prosthetics & Orthotics
• Kailey Soileau Daniel, OD
• Judy Daniels, MHPP
• Peggy Darty
• Christina Davis, MED

• Clinical Social Worker in Blytheville, AR
• Providers in Blytheville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.