Adam Persenaire, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9453-C Issued in AR

Practice address

1441 General Fagan Dr
Prairie Grove, AR 72753-7001

Phone

(479) 879-5916

NPI assigned

Jul 22, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Renewed Oaks Therapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Farmington, AR
  • NPI 1710717392
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1518795657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 GENERAL FAGAN DR",
            "city": "PRAIRIE GROVE",
            "state": "AR",
            "postal_code": "727537001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 GENERAL FAGAN DR",
            "city": "PRAIRIE GROVE",
            "state": "AR",
            "postal_code": "727537001",
            "telephone_number": "479-879-5916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19778 CR-431",
            "address_purpose": "LOCATION",
            "city": "Morrow",
            "state": "AR",
            "postal_code": "72749",
            "country_code": "US",
            "telephone_number": "479-879-5916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSENAIRE",
        "first_name": "ADAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "9453-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Meredith
• Scott Moore
• Amber Morgan, PT, DPT
• Jana Renee Nichols, OTR /L
• Mylena Jo Noble, SLP
• Nicholas Pohlman
• Prairie Grove Dental Center PLLC
• Prairie Grove Health and Rehabilitation LLC
• Sandra Lee Quayle
• Malinda Ann Rector, A.T.C.

• Clinical Social Worker in Prairie Grove, AR
• Providers in Prairie Grove, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.