Active NPI
Stephanie Paige Alsup, LPC
- Professional Counselor
- Walnut Ridge, AR
National Provider Identifier
1255580338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 1425 W Main Street
Walnut Ridge, AR 72476-1431 - Phone
- (870) 886-5303
- Fax
- (870) 886-7002
- NPI assigned
- Sep 15, 2008
- Last updated
- May 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Professional Counselor | 101YP2500X | P1303027 | AR | |
| Professional Counselor | 101YP2500X | AR | Primary |
Addresses
Primary practice location
1425 W Main Street
Walnut Ridge, AR 72476-1431
Mailing address
1815 Pleasant Grove Road
Jonesboro, AR 72405-7870
Phone (870) 933-6886
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 174003795 | Medicaid | AR | |
| 5UU03 | Other | AR | BCBS |
Other names 1
- Stephanie Paige Dicus
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1303027 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1255580338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE ROAD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724057870",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 W MAIN STREET",
"city": "WALNUT RIDGE",
"state": "AR",
"postal_code": "724761431",
"telephone_number": "870-886-5303",
"fax_number": "870-886-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALSUP",
"first_name": "STEPHANIE",
"middle_name": "PAIGE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1303027",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "174003795",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5UU03",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "DICUS",
"middle_name": "PAIGE",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Walnut Ridge, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.