Tynesha Ivory, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2407019 Issued in AR

Practice address

1500 N Mississippi St
Little Rock, AR 72207-5851

Phone

(501) 217-8600

NPI assigned

Jul 18, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• MCT, Inc.

  • Speech-Language Pathologist
  • Little Rock, AR
  • NPI 1881738409

  AR

  Medicare reassignment NPD
• MCT, Inc.

  • Developmental Disabilities Clinic/Center
  • Little Rock, AR
  • NPI 1881005387
  NPD

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1669814745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10618 BRECKENRIDGE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111802",
            "telephone_number": "501-217-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N MISSISSIPPI ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722075851",
            "telephone_number": "501-217-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6210 Baseline Rd",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722094728",
            "country_code": "US",
            "telephone_number": "501-265-0302",
            "fax_number": "501-265-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10618 Breckenridge Dr",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722111802",
            "country_code": "US",
            "telephone_number": "501-217-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVORY",
        "first_name": "TYNESHA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2111000",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2407019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278537795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tesa L Ivey, APN
• Louis Ivins, PT, DPT
• Ivory and Associates
• Ivory Senior Care & DME Company
• Ivory Senior Care & DME Company
• William Ivory
• Ivq Little Rock Opco LP
• Karen Elaine Ivy
• Lisa M Ivy, ANP
• Madalyn Ivy, PHARMD

• All providers in Little Rock, AR
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.