Individual provider Active NPI

Linda Elaine Phillips, MED LICENSED PROFESS

  • Professional Counselor
  • Russellville, AR
National Provider Identifier
1629168067
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P8906008 Issued in AR
Practice address
110 Skyline Drive
Russellville, AR 72801
Phone
(479) 968-1298
Fax
(479) 968-6053
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X P8906008 AR Primary

Addresses

Primary practice location

110 Skyline Drive
Russellville, AR 72801

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
227040719MedicaidAR

Other names 1

  • Linda Elaine Freeman 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
I20231219003741 AR Practitioner - Mental Health Counselor 4183074966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
P8906008ARMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates Inc Current Accepting new patients
Counseling Associates, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Counseling Associates, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

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

110 Skyline Dr
Russellville, AR 72801
Phone 4799675570223

Organizations & group practices 3

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1629168067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SALEM ROAD",
            "address_2": "SUITE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-336-8300",
            "fax_number": "501-329-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SKYLINE DRIVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "72801",
            "telephone_number": "479-968-1298",
            "fax_number": "479-968-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "LINDA",
        "middle_name": "ELAINE",
        "credential": "MED LICENSED PROFESS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P8906008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227040719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "FREEMAN",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.