Organization Active NPI

Pine Bluff Counseling Group, PLLC

  • Clinical Social Worker
  • Pine Bluff, AR
National Provider Identifier
1366955346
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7090-C Issued in AR
Legal business name
PINE BLUFF COUNSELING GROUP, PLLC
Practice address
3104 S Catalpa St Ste 5
Pine Bluff, AR 71603-4869
Phone
(501) 733-5413
NPI assigned
Nov 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Carey James Dobbins, LCSWNPI 1144501503
Title
Owner
Phone
(501) 733-5413

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 7090-C AR Primary

Addresses

Primary practice location

3104 S Catalpa St Ste 5
Pine Bluff, AR 71603-4869

Mailing address

2106 E 6TH Ave
Pine Bluff, AR 71601-5402
Phone (501) 733-5413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190329000399 AR Part B Supplier - Clinic/Group Practice 3678813631 Receives reassigned benefits from 2 practitioners
Practice locations: Ashdown, AR; De Queen, AR; Lonoke, AR; Paris, AR; Pine Bluff, AR

National Provider Directory

National Provider Directory

Locations

3104 S Catalpa St
Ste 5
Pine Bluff, AR 71603
Phone (501) 733-5413

2106 E 6th Ave
Pine Bluff, AR 71601

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1366955346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 E 6TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716015402",
            "telephone_number": "501-733-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 S CATALPA ST STE 5",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034869",
            "telephone_number": "501-733-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE BLUFF COUNSELING GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "DOBBINS",
        "authorized_official_first_name": "CAREY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-733-5413",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7090-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.