Wyatt Flake

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

821 N 10TH St
Fort Smith, AR 72901-1505

Phone

(615) 347-3115

NPI assigned

Mar 10, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Actss a Common Thread Supportive Services

  • Mental Health Counselor
  • Fort Smith, AR
  • NPI 1457984320
  NPD

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1437807310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 N 10TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729011505",
            "telephone_number": "501-766-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N 10TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729011505",
            "telephone_number": "615-347-3115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2714 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Smith",
            "state": "AR",
            "postal_code": "729013106",
            "country_code": "US",
            "telephone_number": "615-347-3115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4288 Cartegena Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891216504",
            "country_code": "US",
            "telephone_number": "615-347-3115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLAKE",
        "first_name": "WYATT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Fitzgerald
• Ashley D Flake, BA, QMHP-C,A
• Blythe Flake, COTA/L
• Chrystel Clotilda Flake, PT,MS
• Jania Flake, ATC
• Alan D Flanagan, MD
• Mary Clare Flanagan, M.D.
• Catherine Elizabeth Flannigan, RNFA, APRN-C
• Randolph P Fleck, MD
• Rebecca A Fleck, MD

• Mental Health Counselor in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.