NPIMap

Organization Active NPI

Lead, Teach, Mentor LLC

Doing business as Thriveworks Conway

  • Community/Behavioral Health Agency
  • Conway, AR
National Provider Identifier
1497167548
Registry record updated May 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
P1204052 Issued in AR
Legal business name
LEAD, TEACH, MENTOR LLC
Doing business as
Thriveworks Conway
Practice address
575 Club LN Ste 103
Conway, AR 72034-3681
Phone
(501) 404-9737
NPI assigned
May 23, 2014
Last updated
May 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2014

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

Authorized official

Name
Mr. Curtiss Howard Robinson, MANPI 1376950188
Title
Ceo/Owner
Phone
(501) 404-9737

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1283-C AR
Community/Behavioral Health Agency 251S00000X P0802024 AR
Community/Behavioral Health Agency 251S00000X 1215208392 AR
Community/Behavioral Health Agency 251S00000X P0909056 AR
Community/Behavioral Health Agency 251S00000X 2533-M AR
Community/Behavioral Health Agency 251S00000X P1204052 AR Primary

Addresses

Primary practice location

575 Club LN Ste 103
Conway, AR 72034-3681

Mailing address

575 Club LN Ste 103
Conway, AR 72034-3681
Phone (501) 404-9737

Other names 1

  • Thriveworks Conway Doing business as

National Provider Directory

National Provider Directory

Locations

575 Club Ln
Ste 103
Conway, AR 72034
Phone (501) 404-9737

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400803200000",
    "number": "1497167548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 CLUB LN STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343681",
            "telephone_number": "501-404-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 CLUB LN STE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343681",
            "telephone_number": "501-404-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAD, TEACH, MENTOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2014-05-23",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "CURTISS",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "501-404-9737",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AR",
            "license": "1283-C",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AR",
            "license": "P0802024",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AR",
            "license": "1215208392",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AR",
            "license": "P0909056",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AR",
            "license": "2533-M",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AR",
            "license": "P1204052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thriveworks Conway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 23, 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.

Verify at the official NPI Registry.