NPIMap

Organization Active NPI

Therapy Assessment Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Conway, AR
National Provider Identifier
1487492153
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
THERAPY ASSESSMENT CENTER LLC
Practice address
317 Oak St Ste 3
Conway, AR 72032-5679
Phone
(501) 358-6396
Fax
(501) 588-0484
NPI assigned
Jul 17, 2024
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
THERAPY ASSESSMENT CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Dr. Samantha Sewell Short, PSYDNPI 1144465139
Title
Owner
Phone
(501) 358-6396

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

317 Oak St Ste 3
Conway, AR 72032-5679

Mailing address

317 Oak St Ste 3
Conway, AR 72032-5679
Phone (501) 358-6396

National Provider Directory

National Provider Directory
Tax ID family
Thpy Assessment Ctr3 organizations share this tax ID, including this one
Part of
Thpy Assessment Ctr

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

317 Oak St
Ste 3
Conway, AR 72032
Phone (501) 291-3091

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1487492153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 OAK ST STE 3",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325679",
            "telephone_number": "501-358-6396",
            "fax_number": "501-588-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 OAK ST STE 3",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325679",
            "telephone_number": "501-358-6396",
            "fax_number": "501-588-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY ASSESSMENT CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THERAPY ASSESSMENT CENTER LLC",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "SEWELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-358-6396",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.