Active NPI
Ellen Ann Burleson, MHPP
- Counselor
- Bentonville, AR
National Provider Identifier
1477702470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2205 Phyllis St
Bentonville, AR 72712-6490 - Phone
- (479) 750-2020
- Fax
- (479) 750-4843
- NPI assigned
- Sep 15, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
2205 Phyllis St
Bentonville, AR 72712-6490
Mailing address
2440 South 48TH St
Springdale, AR 72762
Phone (479) 750-2020
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Guidance Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Springdale, AR
- NPI 1659945194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412208000000",
"number": "1477702470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 SOUTH 48TH ST",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "72762",
"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": "2205 PHYLLIS ST",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727126490",
"telephone_number": "479-750-2020",
"fax_number": "479-750-4843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLESON",
"first_name": "ELLEN",
"middle_name": "ANN",
"credential": "MHPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2014-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.