Active NPI
Nathan Lee Chennault, LCSW
- Clinical Social Worker
- White Hall, AR
National Provider Identifier
1629320122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3518-C
- Practice address
- 7500 Dollarway Rd Ste 401
White Hall, AR 71602-3083 - Phone
- (870) 466-4754
- NPI assigned
- Oct 8, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3518-C | AR | Primary |
Addresses
Primary practice location
7500 Dollarway Rd Ste 401
White Hall, AR 71602-3083
Mailing address
PO Box 622
Sheridan, AR 72150-0622
Phone (870) 466-4754
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200807000149 | AR | Practitioner - Clinical Social Worker | 0547685588 |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
7500 Dollarway Rd
Suite 401
White Hall, AR 71602-3027
PO Box
Suite 622
Sheridan, AR 72150
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594944000000",
"number": "1629320122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 622",
"city": "SHERIDAN",
"state": "AR",
"postal_code": "721500622",
"telephone_number": "870-466-4754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 DOLLARWAY RD STE 401",
"city": "WHITE HALL",
"state": "AR",
"postal_code": "716023083",
"telephone_number": "870-466-4754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENNAULT",
"first_name": "NATHAN",
"middle_name": "LEE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-08",
"last_updated": "2020-07-17",
"certification_date": "2020-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "3518-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Hall, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.