Individual provider Active NPI

Destini Trusty, LPC-S

  • Professional Counselor
  • Conway, AR
National Provider Identifier
1225249774
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
251323 Issued in AR
Practice address
1023 Main St
Suite 211
Conway, AR 72032-5425
Phone
(501) 499-1174
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 251323 AR Primary

Addresses

Primary practice location

1023 Main St
Suite 211
Conway, AR 72032-5425

Mailing address

1023 Main St
Suite 211
Conway, AR 72032-5425
Phone (501) 499-1174

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
I20240528000831 AR Practitioner - Mental Health Counselor 1355752742 Practice locations: Conway, AR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
251323ARMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1225249774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 MAIN ST",
            "address_2": "SUITE 211",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325425",
            "telephone_number": "501-499-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 MAIN ST",
            "address_2": "SUITE 211",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325425",
            "telephone_number": "501-499-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUSTY",
        "first_name": "DESTINI",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "251323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.