Organization Active NPI

Thriveworks Telepsychiatry - Arkansas

  • Mental Health Counselor
  • Fayetteville, AR
National Provider Identifier
1669130928
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
THRIVEWORKS TELEPSYCHIATRY - ARKANSAS
Practice address
300 N College Ave Ste 305
Fayetteville, AR 72701-4381
Phone
(855) 284-7483
NPI assigned
Dec 3, 2021
Last updated
Feb 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Authorized official

Name
Anthony Centore
Title
Ceo
Phone
(540) 217-6461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

300 N College Ave Ste 305
Fayetteville, AR 72701-4381

Mailing address

PO Box 748465
Atlanta, GA 30374-8465
Phone (855) 284-7483

Other practice location 1

1814 Executive Sq
Jonesboro, AR 72401-6085
Phone (855) 284-7483

Other practice location 2

102 Country Club Pkwy Ste A
Maumelle, AR 72113-7048
Phone (855) 284-7483

Other practice location 3

685 Shelby Trl Ste 105
Conway, AR 72034-7169
Phone (855) 284-7483

Other practice location 4

809 SW I St Ste 23
Bentonville, AR 72712-6240
Phone (855) 284-7483

Other practice location 5

4704 W Commercial Dr Ste A
North Little Rock, AR 72116-8040
Phone (855) 284-7483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220427000061 AR Part B Supplier - Clinic/Group Practice 3577950310 Receives reassigned benefits from 5 practitioners
Practice locations: North Little Rock, AR; Conway, AR; Maumelle, AR; Bentonville, AR; Jonesboro, AR

National Provider Directory

National Provider Directory

Locations

809 SW I St
Ste 23
Bentonville, AR 72712
Phone (603) 356-4949

685 Shelby Trl
Ste 105
Conway, AR 72034
Phone (501) 406-0504

102 Country Club Pkwy
Ste A
Maumelle, AR 72113
Phone (501) 628-9066

Practitioners & affiliated clinicians

Practitioners 46

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 46

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1669130928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465",
            "telephone_number": "855-284-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N COLLEGE AVE STE 305",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727014381",
            "telephone_number": "855-284-7483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1814 Executive Sq",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724016085",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Country Club Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Maumelle",
            "state": "AR",
            "postal_code": "721137048",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "685 Shelby Trl Ste 105",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720347169",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 SW I St Ste 23",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727126240",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4704 W Commercial Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721168040",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THRIVEWORKS TELEPSYCHIATRY - ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "CENTORE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "540-217-6461"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.