Individual provider Active NPI

Alicia Diane Henard, CCC-SLP

  • Speech-Language Pathologist
  • Mountain Home, AR
National Provider Identifier
1295887438
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#1090 Issued in AR
Practice address
1409 Highway 201 N Ste 1
Mountain Home, AR 72653-2425
Phone
(870) 508-5010
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#1090 AR Primary

Addresses

Primary practice location

1409 Highway 201 N Ste 1
Mountain Home, AR 72653-2425

Mailing address

1409 Highway 201 N Ste 1
Mountain Home, AR 72653-2425
Phone (870) 508-5010

Other identifiers 1

IdentifierTypeStateIssuer
129315721MedicaidAR

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

LicenseStateTypeSpecialty
SP#1090ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Valach Nephrology, Hypertension and Internal Medicine, PA Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1295887438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 HIGHWAY 201 N STE 1",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532425",
            "telephone_number": "870-508-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 HIGHWAY 201 N STE 1",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532425",
            "telephone_number": "870-508-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENARD",
        "first_name": "ALICIA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129315721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.