Individual provider Active NPI

Mandy Tigert, LPC

  • Professional Counselor
  • Russellville, AR
National Provider Identifier
1215079546
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P1503014 Issued in AR
Practice address
618 S Knoxville Ave
Russellville, AR 72801-6419
Phone
(479) 346-8340
NPI assigned
Feb 13, 2007
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P1503014 AR Primary

Addresses

Primary practice location

618 S Knoxville Ave
Russellville, AR 72801-6419

Mailing address

515 S 4TH St
Dardanelle, AR 72834-4201
Phone (501) 339-6625

Other practice location 1

515 S 4th St
Dardanelle, AR 72834-4201
Phone (501) 339-6625

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
I20241030003338 AR Practitioner - Mental Health Counselor 0941733828 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor House Incorporated of Fort Smith Arkansas CurrentSince Sep 15, 2024 Accepting new patients
Perspectives Behavioral Health Management, LLC Past Accepting new patients
Perspectives Behavioral Health Management, LLC Counselor Past Accepting new patients

Locations

130 N College Ave
Ste G
Fayetteville, AR 72701

3811 Rogers Ave
Fort Smith, AR 72903
Phone (479) 395-1599

620 S 21st St
Fort Smith, AR 72901
Phone (479) 395-1599

1200 W Walnut St
Rogers, AR 72756
Phone (479) 631-9996

702 E 4th St
Russellville, AR 72801
Phone (479) 518-6028

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1215079546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S 4TH ST",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728344201",
            "telephone_number": "501-339-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 S KNOXVILLE AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728016419",
            "telephone_number": "479-346-8340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Dardanelle",
            "state": "AR",
            "postal_code": "728344201",
            "country_code": "US",
            "telephone_number": "501-339-6625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIGERT",
        "first_name": "MANDY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1503014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.