Individual provider Active NPI

Monica Anne Dunn, LCSW

  • Clinical Social Worker
  • Conway, AR
National Provider Identifier
1508968140
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1588-C Issued in AR
Practice address
350 Salem Rd Ste 1
Conway, AR 72034-6166
Phone
(501) 336-8300
Fax
(501) 329-5508
NPI assigned
Sep 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1588-C AR Primary

Addresses

Primary practice location

350 Salem Rd Ste 1
Conway, AR 72034-6166

Mailing address

2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020

Other identifiers 1

IdentifierTypeStateIssuer
1588-CMedicaidAR

Other names 1

  • Monica Anne Ruckle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826001276 AR Practitioner - Clinical Social Worker 9739203704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Counseling Associates IncGroup PAC ID 3173583564, 33 clinicians

Practice addresses (Care Compare)

350 Salem Rd
Suite 1
Conway, AR 72034-6166
Phone (501) 336-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1588-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates Inc CurrentSince Jul 1, 2002 Accepting new patients
Counseling Associates, Inc. CurrentSince Jul 1, 2002 Accepting new patients

Locations

350 Salem Rd
Conway, AR 72034
Phone (501) 327-2995

350 Salem Rd
Ste 1
Conway, AR 72034
Phone (501) 336-8300

110 Skyline Dr
Russellville, AR 72801
Phone 4799675570223

2400 S 48th St
Springdale, AR 72762
Phone (479) 725-5115

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1508968140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SALEM RD STE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346166",
            "telephone_number": "501-336-8300",
            "fax_number": "501-329-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "MONICA",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1588-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588-C",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONICA",
            "last_name": "RUCKLE",
            "middle_name": "ANNE",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.