Monica G Brannon, LPC
Individual provider Active NPI Professional Counselor · Hope, AR
NPI 1497800486 · NPPES record last updated Apr 6, 2022
Key facts
- NPI
- 1497800486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- P0711063 (AR)
- Practice address
- 112 E 12TH St
Hope, AR 71801-7307 - Phone
- (870) 474-5001
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240130002096 | AR | Practitioner - Mental Health Counselor | 7012375272 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0711063 | AR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Experience Counseling Clinic, Inc. | Current |
Accepting new patients | |
| Experience Counseling Clinic, Inc. | Past | Accepting new patients | |
| Experience Counseling Clinic, Inc. | Past | Accepting new patients |
Locations
1209 Ferguson Dr
Benton, AR 72015
Phone (870) 407-5001
509 S Main St
Hope, AR 71801
Phone (870) 474-5001
112 E 12th St
Hope, AR 71801
Phone (870) 474-5001
114 Medical Park Dr
Hope, AR 71801
Phone (870) 474-5001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P0711063 | AR | Yes |
Addresses
Primary practice location
112 E 12TH St
Hope, AR 71801-7307
Mailing address
PO Box 113
Delight, AR 71940-0113
Phone (870) 474-5001
Other providers in Hope, AR
- Dewayne Bonner
- Karcee Bonner
- Destiny Bowman
- Julie Rodgers Boyett
- Ryan Bradley
- Joseph Austin Brill
- Brim Holding Company, Inc.
- Brim Holding Company, Inc.
- Brim Holding Company, Inc.
- Meagan Broach
All providers in Hope, AR · Professional Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.