Individual provider Active NPI

Bianca Weber, LCSW

  • Clinical Social Worker
  • Paragould, AR
National Provider Identifier
1467877654
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7544-C Issued in AR
Practice address
1707 Linwood Dr Ste G
Paragould, AR 72450-5365
Phone
(870) 604-4455
NPI assigned
Feb 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7544M AR
Social Worker 104100000X 7544-M AR
Clinical Social Worker 1041C0700X 7544-C AR Primary

Addresses

Primary practice location

1707 Linwood Dr Ste G
Paragould, AR 72450-5365

Mailing address

1707 Linwood Dr Ste G
Paragould, AR 72450-5365
Phone (870) 604-4455

Other names 1

  • Bianca Jordan 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
I20230721001943 AR Practitioner - Clinical Social Worker 5294195244 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7544-MARMDSocial Worker
7544MARMDSocial Worker
7544-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nextstep Counseling Services, LLC CurrentSince Jun 13, 2023 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Clinical PastSince Feb 1, 2020 Accepting new patients
Optum Behavioral Care of North Carolina, PC PastSince Feb 1, 2020 Accepting new patients

Locations

1707 Linwood Dr
Ste G
Paragould, AR 72450
Phone (870) 604-4455

1707 Linwood Dr
Ste B
Paragould, AR 72450
Phone (870) 215-0669

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": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1467877654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 LINWOOD DR STE G",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505365",
            "telephone_number": "870-604-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 LINWOOD DR STE G",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505365",
            "telephone_number": "870-604-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "BIANCA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "7544M",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "7544-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7544-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BIANCA",
            "last_name": "JORDAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.