NPIMap

Organization Active NPI

River Valley Psychology PLLC

  • Psychologist
  • Russellville, AR
National Provider Identifier
1235424326
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
09-16P Issued in AR
Legal business name
RIVER VALLEY PSYCHOLOGY PLLC
Practice address
3101 West 2ND CT
Russellville, AR 72801
Phone
(479) 567-5654
Fax
(479) 567-5661
NPI assigned
Jun 16, 2011
Last updated
Jan 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Authorized official

Name
Leslie A Blanchard, PH.D.NPI 1154579902
Title
Owner
Phone
(479) 567-5654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X P1611170 AR
Psychologist 103T00000X 09-16P AR Primary
Clinical Psychologist 103TC0700X 09-16P AR

Addresses

Primary practice location

3101 West 2ND CT
Russellville, AR 72801

Mailing address

P.O. Box 10323
Russellville, AR 72812
Phone (479) 567-5654

National Provider Directory

National Provider Directory

Locations

3101 W 2nd Ct
Russellville, AR 72801
Phone (479) 567-5654

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1235424326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10323",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72812",
            "telephone_number": "479-567-5654",
            "fax_number": "479-567-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 WEST 2ND CT",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-567-5654",
            "fax_number": "479-567-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER VALLEY PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-567-5654",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "P1611170",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "09-16P",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "09-16P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.