Individual provider Active NPI

Alison N Tait, PHD

  • Clinical Psychologist
  • Rogers, AR
National Provider Identifier
1366479669
Registry record updated May 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
16-21P Issued in AR
Practice address
3333 S Pinnacle Hills Pkwy Ste 435
Rogers, AR 72758-9095
Phone
(479) 235-4146
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 16-21P AR Primary
Clinical Psychologist 103TC0700X 261 ND

Addresses

Primary practice location

3333 S Pinnacle Hills Pkwy Ste 435
Rogers, AR 72758-9095

Mailing address

3333 S Pinnacle Hills Pkwy Ste 435
Rogers, AR 72758-9095
Phone (479) 235-4146

Other identifiers 2

IdentifierTypeStateIssuer
18125MedicaidND
867817100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180718001385 AR Practitioner - Clinical Psychologist 1153354600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Wind Psychological Services 2 clinicians

Practice addresses (Care Compare)

3333 S Pinnacle Hills Pkwy
Suite 435
Rogers, AR 72758-9095
Phone (479) 235-4146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Chenal Family Therapy, PLC CurrentSince May 8, 2018 Accepting new patients
South Wind Psychological Services CurrentSince May 1, 2024 Accepting new patients
Transitions Counseling Clinic PLC Clinical PastSince Apr 9, 2023 Accepting new patients

Locations

803 SE Plaza Ave
Ste 7
Bentonville, AR 72712

304 W Collin Raye Dr
Ste 103A
De Queen, AR 71832
Phone (870) 200-9294

10311 W Markham St
Little Rock, AR 72205
Phone (501) 681-3300

3333 S Pinnacle Hills Pkwy
Ste 435
Rogers, AR 72758
Phone (479) 235-4146

Organizations & group practices 3

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1366479669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S PINNACLE HILLS PKWY STE 435",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589095",
            "telephone_number": "479-235-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S PINNACLE HILLS PKWY STE 435",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589095",
            "telephone_number": "479-235-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAIT",
        "first_name": "ALISON",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "16-21P",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18125",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "867817100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.