Chancy Bethea, M.S., PLPE

Key facts

NPI

1295039758

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

11-12EI (AR)

Practice address

1900 Aldersgate Rd
Little Rock, AR 72205

Phone

(501) 821-5459

Fax

(501) 821-6116

NPI assigned

Dec 27, 2010

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 24, 2018.

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1295039758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 EXCHANGE AVE STE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327836",
            "telephone_number": "501-328-3274",
            "fax_number": "501-358-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ALDERSGATE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72205",
            "telephone_number": "501-821-5459",
            "fax_number": "501-821-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "CHANCY",
        "credential": "M.S., PLPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-27",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "11-12EI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Little Rock, AR · Mental Health Counselor in Arkansas