William Brad Maddox, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P2111008 Issued in AR

Practice address

200 E Main St
Clarksville, AR 72830-3724

Phone

(479) 705-1634

Fax

(479) 705-1635

NPI assigned

Apr 28, 2010

Last updated

Dec 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• William B. Maddox PA

  • Professional Counselor
  • Clarksville, AR
  • NPI 1437802030
  NPD Authorized official

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1659698736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303724",
            "telephone_number": "479-705-1634",
            "fax_number": "479-705-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728303724",
            "telephone_number": "479-705-1634",
            "fax_number": "479-705-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX",
        "first_name": "WILLIAM",
        "middle_name": "BRAD",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1909134",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2111008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Luht
• Brandy Lujan, RECOVERY ASSISTANT
• Hannah Morgan Lutz, CRNA
• Elyse Maag
• Lakin R Maddox, LPC
• Christy Mann, CMP
• Cheyenne Manning
• Roxanne Marshall, M.D.
• Marty J. Harderson, DDS, PA
• Rachael Masters, COTA/L

• Mental Health Counselor in Clarksville, AR
• Providers in Clarksville, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.