Mandy K Hall

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2401007 Issued in AR

Practice address

103 Calvary LN
Judsonia, AR 72081-9324

Phone

(501) 720-0777

Fax

(870) 770-7177

NPI assigned

Jun 15, 2022

Last updated

Mar 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Baptist Children's Homes and Family MinistriesGroup PAC ID 3173023017, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arkansas Baptist Children's Homes and Family Ministries

  dba Living Well Professional Counseling

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1972159267

  Professional

  Medicare reassignment Care Compare group NPD
• Every Season Women's and Girls Counseling

  • Professional Counselor
  • Judsonia, AR
  • NPI 1265307912
  NPD Authorized official
• Arkansas Baptist Children's Homes

  • Community/Behavioral Health Agency
  • Little Rock, AR
  • NPI 1649639113
  NPD (past)

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1619607207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30022",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722600001",
            "telephone_number": "501-455-8554",
            "fax_number": "870-770-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CALVARY LN",
            "city": "JUDSONIA",
            "state": "AR",
            "postal_code": "720819324",
            "telephone_number": "501-720-0777",
            "fax_number": "870-770-7177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1507 N Pecan St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "AR",
            "postal_code": "721122867",
            "country_code": "US",
            "telephone_number": "870-919-8432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "MANDY",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "A2401007",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2401007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanna M. Fisher, M.S., CCC-SLP
• Rachel Foote, LAC
• Matthew Foster
• Megan Nicole Glaze, M.S.
• Tiffany Marie Gormany, LAC
• Zachary Haugh
• William Adrian Hickmon, PH.D.
• Taylor Holsonback
• Jordan Terry Howard, LPC
• Elizabeth Anne Howey, DO

• Professional Counselor in Judsonia, AR
• Providers in Judsonia, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.