Active NPI
Counseling Services of Eastern Arkansas
- Community/Behavioral Health Agency
- Wynne, AR
National Provider Identifier
1508017948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- COUNSELING SERVICES OF EASTERN ARKANSAS
- Practice address
- 1201 Falls Blvd S
Wynne, AR 72396-3637 - Phone
- (870) 238-1135
- Fax
- (870) 972-4911
- NPI assigned
- Oct 3, 2008
- Organization subpart
- Yes
- Parent organization
- COUNSELING SERVICES OF EASTERN ARKANSAS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donnie Lyerly
- Title
- Provider Credentialing
- Phone
- (870) 972-4939
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1201 Falls Blvd S
Wynne, AR 72396-3637
Mailing address
2707 Browns LN
Jonesboro, AR 72401-7213
Phone (870) 972-4939
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 172101526 | Medicaid | AR |
National Provider Directory
National Provider Directory- Part of
- Counseling Services of
Locations
1201 Falls Blvd S
Wynne, AR 72396
Phone (870) 238-1135
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.
-
- Community/Behavioral Health Agency
- Jonesboro, AR
- NPI 1851351712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1355270400000",
"number": "1508017948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2707 BROWNS LN",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724017213",
"telephone_number": "870-972-4939",
"fax_number": "870-972-4911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 FALLS BLVD S",
"city": "WYNNE",
"state": "AR",
"postal_code": "723963637",
"telephone_number": "870-238-1135",
"fax_number": "870-972-4911"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNSELING SERVICES OF EASTERN ARKANSAS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COUNSELING SERVICES OF EASTERN ARKANSAS",
"enumeration_date": "2008-10-03",
"last_updated": "2012-12-12",
"status": "A",
"authorized_official_last_name": "LYERLY",
"authorized_official_first_name": "DONNIE",
"authorized_official_title_or_position": "PROVIDER CREDENTIALING",
"authorized_official_telephone_number": "870-972-4939"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172101526",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wynne, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.