NPIMap

Organization Active NPI

Therapy Services of Northwest Arkansas, LLC

  • Speech-Language Pathologist
  • Berryville, AR
National Provider Identifier
1639440324
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#1969 Issued in AR
Legal business name
THERAPY SERVICES OF NORTHWEST ARKANSAS, LLC
Practice address
1004 S Main St
Berryville, AR 72616-4330
Phone
(870) 654-3869
Fax
(870) 505-2016
NPI assigned
Jan 26, 2012
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Tricia Lynnette George, M.S. CCC-SLPNPI 1154544542
Title
Owner/Operator
Phone
(870) 654-3869

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU
Physical Therapy Assistant 225200000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X SP#1969 AR Primary

Addresses

Primary practice location

1004 S Main St
Berryville, AR 72616-4330

Mailing address

27104 Pine Bluff LN
Golden, MO 65658-8381
Phone (417) 271-9122

Other practice location 1

600 W Central Ave
Harrison, AR 72601-5006
Phone (870) 654-3869

Other identifiers 1

IdentifierTypeStateIssuer
191773742MedicaidAR

National Provider Directory

National Provider Directory

Locations

1004 S Main St
Berryville, AR 72616
Phone (870) 423-1077

806 W College Ave
Berryville, AR 72616
Phone (870) 423-3000

600 W Central Ave
Harrison, AR 72601
Phone (870) 654-3869

916 Goblin Dr
Harrison, AR 72601
Phone (870) 204-5330

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1639440324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27104 PINE BLUFF LN",
            "city": "GOLDEN",
            "state": "MO",
            "postal_code": "656588381",
            "telephone_number": "417-271-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S MAIN ST",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726164330",
            "telephone_number": "870-654-3869",
            "fax_number": "870-505-2016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "AR",
            "postal_code": "726015006",
            "country_code": "US",
            "telephone_number": "870-654-3869",
            "fax_number": "870-505-2016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPY SERVICES OF NORTHWEST ARKANSAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2022-04-27",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_middle_name": "LYNNETTE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "870-654-3869",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191773742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.