Amy Diede, LAC
Individual provider Active NPI Counselor · Barling, AR
NPI 1497784607 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497784607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- A0210072 (AR)
- Practice address
- 10301 Mayo Dr
Barling, AR 72923-1660 - Phone
- (479) 494-5760
- Fax
- (479) 484-8142
- NPI assigned
- Jul 1, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0210072 | AR | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | A0210072 | AR | Yes |
Addresses
Primary practice location
10301 Mayo Dr
Barling, AR 72923-1660
Mailing address
4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 521-5731
Other names
- Amy Rochelle Beshears
Other providers in Barling, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.