Center for Eating Disorders and Behavioral Wellness PLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6572-C Issued in AR

Legal business name

CENTER FOR EATING DISORDERS AND BEHAVIORAL WELLNESS PLC

Practice address

218 Union St Ste C
Jonesboro, AR 72401-2831

Phone

(870) 530-6104

NPI assigned

Jun 21, 2018

Last updated

Mar 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keena ReddinNPI 1497110043

Title

Owner

Phone

(870) 761-4796

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keena Michelle Reddin, LCSW

  • Clinical Social Worker
  • Jonesboro, AR
  • NPI 1497110043
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616889600000",
    "number": "1336633387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 UNION ST STE C",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724012831",
            "telephone_number": "870-530-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 UNION ST STE C",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724012831",
            "telephone_number": "870-530-6104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 S Main St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "72401",
            "country_code": "US",
            "telephone_number": "870-761-4796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR EATING DISORDERS AND BEHAVIORAL WELLNESS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-21",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A",
        "authorized_official_last_name": "REDDIN",
        "authorized_official_first_name": "KEENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-761-4796"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6572-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleigh Catt
• Chelsey Catt, APRN
• Merrill Kay Catt, MSP, CCC-SLP
• Caitlyn Caubble
• Mario Cauli, M.D.
• Center for Pediatric Neuroscience, PLLC
• Central Healthcare
• Charles Cesare Jr., MD
• Catelyn Chadwick
• Cally Chalker

• Clinical Social Worker in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.