NPIMap

Organization Active NPI

Arkansas Counseling and Psychodiagnostics, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Arkadelphia, AR
National Provider Identifier
1356838569
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
ARKANSAS COUNSELING AND PSYCHODIAGNOSTICS, INC.
Practice address
2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307
Phone
(870) 230-8217
Fax
(870) 230-8201
NPI assigned
Apr 13, 2018
Organization subpart
Yes
Parent organization
ARKANSAS COUNSELING & PSYCHODIAGNOSTICS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Authorized official

Name
Charles Adolph Weiner, PSYCHOLOGIST
Title
Vice President/Coo
Phone
(870) 230-8217

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307

Mailing address

2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307
Phone (870) 230-8217

Other practice location 1

321 E 13th St
Murfreesboro, AR 71958-9541
Phone (870) 285-3669

Other identifiers 2

IdentifierTypeStateIssuer
181395526MedicaidAR
222173526MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Counseling and Psychodiagnostics Inc2 organizations share this tax ID, including this one
Part of
Arkansas Counseling and Psychodiagnostics Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

321 E 13th St
Murfreesboro, AR 71958
Phone (870) 230-8217

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 140

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 140

NPI Registry JSON

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1356838569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 CADDO ST STE 6",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235307",
            "telephone_number": "870-230-8217",
            "fax_number": "870-230-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 CADDO ST STE 6",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235307",
            "telephone_number": "870-230-8217",
            "fax_number": "870-230-8201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 E 13th St",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "AR",
            "postal_code": "719589541",
            "country_code": "US",
            "telephone_number": "870-285-3669",
            "fax_number": "870-285-3771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARKANSAS COUNSELING AND PSYCHODIAGNOSTICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARKANSAS COUNSELING & PSYCHODIAGNOSTICS, INC.",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ADOLPH",
        "authorized_official_title_or_position": "VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "870-230-8217",
        "authorized_official_credential": "PSYCHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181395526",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222173526",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arkadelphia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.