NPIMap

Organization Active NPI

Western Arkansas Counseling & Guidance Center, Inc.-31St Street Clinic

  • Community/Behavioral Health Agency
  • Fort Smith, AR
National Provider Identifier
1649501461
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC.-31ST STREET CLINIC
Practice address
2100 N 31St St
Fort Smith, AR 72904-6140
Phone
(479) 452-6650
Fax
(479) 785-9495
NPI assigned
Jan 18, 2010
Organization subpart
Yes
Parent organization
WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Mr. Jim West, LCSW
Title
Ceo
Phone
(479) 452-6650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2100 N 31St St
Fort Smith, AR 72904-6140

Mailing address

PO Box 11818
Fort Smith, AR 72917-1818
Phone (479) 452-6650

Other identifiers 1

IdentifierTypeStateIssuer
181576526MedicaidAR

Other names 1

  • WACGC - 31st Street Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
The Guidance Center - Whole Health30 organizations share this tax ID, including this one
Part of
The Guidance Center - Whole Health

Other organizations with this tax ID 29

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

View all 29

Locations

2100 N 31st St
Fort Smith, AR 72904

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1649501461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11818",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171818",
            "telephone_number": "479-452-6650",
            "fax_number": "479-785-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N 31ST ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729046140",
            "telephone_number": "479-452-6650",
            "fax_number": "479-785-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC.-31ST STREET CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC.",
        "enumeration_date": "2010-01-18",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-452-6650",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181576526",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WACGC - 31st Street Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.