Heidi Nicole Jansen – Speech-Language Pathologist

Key facts

NPI: 1598890964
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 1640 (AR)
Practice address: 1500 Wilson Loop
Ward, AR 72176
Phone: (501) 941-5630
NPI assigned: Feb 23, 2007
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

Allied Therapy and Consulting Services, PA Specialist · North Little Rock, AR · NPI 1134185937

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
1640	AR	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Allied Therapy and Consulting Services, PA		Past since Apr 24, 2019	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	1640	AR	Yes

Addresses

Primary practice location

1500 Wilson Loop
Ward, AR 72176

Mailing address

12319 Woodbourne Dr
Little Rock, AR 72211-4191
Phone (501) 312-0479

Other identifiers

Identifier	Type	State	Issuer
5U635	Other		BCBS #

Other providers in Ward, AR

All providers in Ward, AR · Speech-Language Pathologist in Arkansas

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.

Verify at the official NPI Registry.