Active NPI
Anna C Mendenhall, LCSW
- Clinical Social Worker
- Fayetteville, AR
National Provider Identifier
1336555309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7371-C
- Practice address
- 1 W Sunbridge Dr
Fayetteville, AR 72703-1825 - Phone
- (479) 366-0779
- Fax
- (479) 443-9554
- NPI assigned
- Jul 10, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7371-M | AR | |
| Clinical Social Worker | 1041C0700X | 7371-C | AR | Primary |
Addresses
Primary practice location
1 W Sunbridge Dr
Fayetteville, AR 72703-1825
Mailing address
1 W Sunbridge Dr
Fayetteville, AR 72703-1825
Phone (479) 366-0779
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7371-M | AR | MD | Social Worker |
| 7371-C | AR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1336555309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 W SUNBRIDGE DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727031825",
"telephone_number": "479-366-0779",
"fax_number": "479-443-9554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W SUNBRIDGE DR",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727031825",
"telephone_number": "479-366-0779",
"fax_number": "479-443-9554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDENHALL",
"first_name": "ANNA",
"middle_name": "C",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-10",
"last_updated": "2022-09-08",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "7371-M",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "7371-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.