Individual provider Active NPI

Amanda Jane Smart, LPC

  • Professional Counselor
  • Siloam Springs, AR
National Provider Identifier
1376711762
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P1012079 Issued in AR
Practice address
710 S Holly St
Siloam Springs, AR 72761-3304
Phone
(479) 524-8618
Fax
(479) 750-4843
NPI assigned
Feb 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P1012079 AR Primary

Addresses

Primary practice location

710 S Holly St
Siloam Springs, AR 72761-3304

Mailing address

2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020

Other names 1

  • Amanda J Harrison Former name

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
I20240515003007 AR Practitioner - Mental Health Counselor 0840631362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
PT Concepts PLLCGroup PAC ID 1951669852, 25 clinicians

Practice addresses (Care Compare)

1200 W Walnut St
Suite 3101
Rogers, AR 72756-3521
Phone (479) 621-0301

204 S 24TH St
Rogers, AR 72758-1129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P1012079ARMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
PT Concepts, PLLC Professional CurrentSince Apr 22, 2024 Accepting new patients
Ozark Guidance Center, Inc Past Accepting new patients
My Therapy LLC PastSince Nov 8, 2025 Accepting new patients

Locations

1200 W Walnut St
Ste 3101
Rogers, AR 72756
Phone (479) 621-0301

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1376711762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S HOLLY ST",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727613304",
            "telephone_number": "479-524-8618",
            "fax_number": "479-750-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMART",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1012079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HARRISON",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Siloam Springs, AR

Sources for this page

Verify at the official NPI Registry.