Individual provider Active NPI

Shannon Fletcher

  • Mental Health Counselor
  • Little Rock, AR
National Provider Identifier
1649343070
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A0903038 Issued in AR
Practice address
2 Innwood Cir Ste a
Little Rock, AR 72211-2490
Phone
(501) 954-7470
Fax
(501) 954-7420
NPI assigned
Nov 15, 2006
Last updated
Oct 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0095961 NM
Mental Health Counselor 101YM0800X A0903038 AR Primary
School Counselor 101YS0200X NM
School Counselor 101YS0200X AR
Art Therapist 221700000X A0903038 AR

Addresses

Primary practice location

2 Innwood Cir Ste a
Little Rock, AR 72211-2490

Mailing address

2 Innwood Cir Ste a
Little Rock, AR 72211-2490
Phone (501) 954-7470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0095961NMMDMental Health Counselor
A0903038ARMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1649343070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 INNWOOD CIR STE A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112490",
            "telephone_number": "501-954-7470",
            "fax_number": "501-954-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INNWOOD CIR STE A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112490",
            "telephone_number": "501-954-7470",
            "fax_number": "501-954-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0095961",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A0903038",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "AR",
            "license": "A0903038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.