Individual provider Active NPI

Kizer Contrel Neal, MSW, LCSW

  • Clinical Social Worker
  • Texarkana, AR
National Provider Identifier
1366772386
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
66235 Issued in TX
Practice address
4613 Parkway Dr Ste 5
Texarkana, AR 71854-1142
Phone
(918) 510-6066
NPI assigned
Jan 14, 2010
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X OK
Clinical Social Worker 1041C0700X CSW004456 GA
Clinical Social Worker 1041C0700X 7458-C AR
Clinical Social Worker 1041C0700X 66235 TX Primary

Addresses

Primary practice location

4613 Parkway Dr Ste 5
Texarkana, AR 71854-1142

Mailing address

4613 Parkway Dr Ste 5
Texarkana, AR 71854-1142
Phone (918) 510-6066

Other practice location 1

1516 S Boston Ave
Suite 100
Tulsa, OK 74119-4003
Phone (918) 561-6000 ext. 235

Other practice location 2

4099 Summerhill Sq
Texarkana, TX 75503-2768
Phone (870) 587-7021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171212000713 AR Practitioner - Clinical Social Worker 0840558326 Reassigns benefits to 2 organizations
I20181025002679 TX Practitioner - Clinical Social Worker 0840558326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4099 Summerhill SQ
Texarkana, TX 75503-2768
Phone 8705877021700

4613 Pkwy Dr
Suite 5
Texarkana, AR 71854-1191
Phone 8705877021700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004456GAMDClinical Social Worker
66235TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Dream Lab CurrentSince Nov 29, 2017 Accepting new patients
Arkansas Psychiatric Clinic Clinical Research Trials, PA CurrentSince Oct 25, 2017 Accepting new patients

Locations

4 Executive Center Ct
Little Rock, AR 72211
Phone (501) 448-0060

4613 Parkway Dr
Ste 5
Texarkana, AR 71854
Phone (870) 587-7021

2411 Summerhill Rd
Texarkana, TX 75501
Phone (918) 510-6066

4099 Summerhill Sq
Texarkana, TX 75503
Phone (870) 587-7021

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1366772386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 PARKWAY DR STE 5",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541142",
            "telephone_number": "918-510-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 PARKWAY DR STE 5",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541142",
            "telephone_number": "918-510-6066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1516 S Boston Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741194003",
            "country_code": "US",
            "telephone_number": "918-561-6000 x235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4099 Summerhill Sq",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755032768",
            "country_code": "US",
            "telephone_number": "870-587-7021",
            "fax_number": "870-275-4860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEAL",
        "first_name": "KIZER",
        "middle_name": "CONTREL",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-14",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004456",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7458-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, AR

Sources for this page

Verify at the official NPI Registry.