Active NPI
Kristi Dale Merrick, LAC
- Professional Counselor
- Cabot, AR
National Provider Identifier
1487373437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A2208001
- Practice address
- 12406 Highway 5 Ste C
Cabot, AR 72023-7657 - Phone
- (501) 781-2230
- NPI assigned
- Aug 23, 2022
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A2208001 | AR | Primary |
Addresses
Primary practice location
12406 Highway 5 Ste C
Cabot, AR 72023-7657
Mailing address
1530 WR Stephens Dr
Cabot, AR 72023-5067
Phone (501) 605-3562
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 |
|---|---|---|---|
| A2208001 | AR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chenal Family Therapy, PLC | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1487373437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 WR STEPHENS DR",
"city": "CABOT",
"state": "AR",
"postal_code": "720235067",
"telephone_number": "501-605-3562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12406 HIGHWAY 5 STE C",
"city": "CABOT",
"state": "AR",
"postal_code": "720237657",
"telephone_number": "501-781-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRICK",
"first_name": "KRISTI",
"middle_name": "DALE",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-23",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "A2208001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.