Priscilla Ann Faulkner, LPC
Individual provider Active NPI Mental Health Counselor · Dierks, AR
NPI 1457594848 · NPPES record last updated Aug 20, 2021
Key facts
- NPI
- 1457594848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- A1003032 (AR)
- Practice address
- 1124 Main Ave
Dierks, AR 71833-9421 - Phone
- (187) 028-5141
- Fax
- (870) 825-2060
- NPI assigned
- Apr 14, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1003032 | AR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Counseling Clinic, Incorporated | Mental Health | Current |
Accepting new patients |
| Impact Counseling Clinic, Incorporated | Current | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/25972/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A1003032 | AR | Yes |
Addresses
Primary practice location
1124 Main Ave
Dierks, AR 71833-9421
Mailing address
PO Box 575
Dierks, AR 71833-0575
Phone (870) 285-1413
Other practice location 1
248 Highway 70 E
Glenwood, AR 71943-8801
Phone (870) 356-4801
Other providers in Dierks, AR
- Kelsi Dawn Brown
- Dierks Health Opco LLC
- Dierks Healthcare & Rehabilitation Center LLC
- Dierks School District
- Hannah Nicole Ellis
- Shelby Gail Foshee
- Robert Ernest Gunter
- Impact Counseling Clinic, Incorporated
- Jen&Josh Inc
- Jennifer Leigh Jones
All providers in Dierks, AR · Mental Health Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.