Active NPI
Melissa Jo McCready, LPE-I
- Clinical Psychologist
- Malvern, AR
National Provider Identifier
1407029606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 06-11EI
- Practice address
- 829 Halbert St
Malvern, AR 72104-2607 - Phone
- (501) 332-4400
- Fax
- (870) 246-4184
- NPI assigned
- Apr 8, 2008
- Last updated
- Jul 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 06-11EI | AR | Primary |
Addresses
Primary practice location
829 Halbert St
Malvern, AR 72104-2607
Mailing address
829 Halbert St
Malvern, AR 72104-2607
Phone (501) 332-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227955719 | Medicaid | AR |
Other names 1
- Melissa Jo Long
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06-11EI | AR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Auremelle Counseling | Past | Accepting new patients | |
| Ouachita Regional Counseling & Mental Health Center, Inc. | Past | Accepting new patients | |
| Ouachita Regional Counseling and Mental Health Center, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Auremelle Counseling and Wellness
- Professional Counselor
- Arkadelphia, AR
- NPI 1285338756
-
dba Community Counseling Services, Inc.
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Arkadelphia, AR
- NPI 1699928135
-
dba Next Level Life Solutions
- Community/Behavioral Health Agency
- Benton, AR
- NPI 1780440305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1407029606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "829 HALBERT ST",
"city": "MALVERN",
"state": "AR",
"postal_code": "721042607",
"telephone_number": "501-332-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "829 HALBERT ST",
"city": "MALVERN",
"state": "AR",
"postal_code": "721042607",
"telephone_number": "501-332-4400",
"fax_number": "870-246-4184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCREADY",
"first_name": "MELISSA",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "LPE-I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "06-11EI",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "227955719",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "LONG",
"middle_name": "JO",
"credential": "LPE-I",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Malvern, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.