Tyreesha McCollum

Primary specialty

Social WorkerTaxonomy code 104100000X

License

PLMSW Issued in AR

Practice address

1600 Aldersgate Rd Ste 100
Little Rock, AR 72205-6676

Phone

(501) 537-3991

NPI assigned

Apr 3, 2024

Last updated

Sep 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/youthhome/r4/

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

• United Methodist Behavioral Health System, Inc

  • Community/Behavioral Health Agency
  • Little Rock, AR
  • NPI 1093621948
  NPD (past)
• United Methodist Behavioral Health System, Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Little Rock, AR
  • NPI 1508020132
  NPD (past)
• Youth Home Inc

  dba Behavioral Health Services of Arkansas

  • Psychiatric Residential Treatment Facility
  • Little Rock, AR
  • NPI 1942266879
  NPD (past)

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1316799224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ALDERSGATE RD STE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056676",
            "telephone_number": "501-661-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ALDERSGATE RD STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056676",
            "telephone_number": "501-537-3991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20400 Colonel Glenn Rd",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722105323",
            "country_code": "US",
            "telephone_number": "501-821-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "TYREESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "PLMSW",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katlyn Reine McClure, PA
• Timothy Patrick McClure, M.D.
• Carol McCluskey, SLP
• Edgar Bornman McColgan, PH.D.
• Neesa J McCollum Flaxman, M.D.
• Michael McConnaughhay, ATC
• Lindsey C McConnell
• Zachary McConnell
• Mary Kathryn McCool, AGACNP-BC
• Megan McCorkindale, PHARMD

• Social Worker in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.