NPIMap

Organization Active NPI

Therapy Assessment Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Conway, AR
National Provider Identifier
1629800099
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
THERAPY ASSESSMENT CENTER LLC
Practice address
317 Oak St
Conway, AR 72032-4617
Phone
(501) 358-6396
NPI assigned
Aug 15, 2024
Organization subpart
Yes
Parent organization
THERAPY ASSESSMENT CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Samantha Sewell Short, PSYDNPI 1144465139
Title
Owner
Phone
(501) 350-6785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

317 Oak St
Conway, AR 72032-4617

Mailing address

317 Oak St
Conway, AR 72032-4617
Phone (501) 358-6396

National Provider Directory

National Provider Directory
Tax ID family
Thpy Assessment Ctr3 organizations share this tax ID, including this one
Part of
Thpy Assessment Ctr

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1629800099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 OAK ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324617",
            "telephone_number": "501-358-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 OAK ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324617",
            "telephone_number": "501-358-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY ASSESSMENT CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THERAPY ASSESSMENT CENTER LLC",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "SEWELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-350-6785",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.