Individual provider Active NPI

Eric I Phelps, PHD, LCSW, CGP

  • Clinical Social Worker
  • Little Rock, AR
National Provider Identifier
1679609937
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2293-C Issued in AR
Practice address
1922 Pine Valley Rd
Little Rock, AR 72207-1817
Phone
(501) 680-4239
NPI assigned
Feb 23, 2007
Last updated
Jul 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2293-C AR Primary

Addresses

Primary practice location

1922 Pine Valley Rd
Little Rock, AR 72207-1817

Mailing address

1922 Pine Valley Rd
Little Rock, AR 72207-1817
Phone (501) 680-4239

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130924000563 AR Practitioner - Clinical Social Worker 8820231509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3000 Kavanaugh Blvd
Suite 206a
Little Rock, AR 72205-3769
Phone (501) 680-4239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2293-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Clinic, Inc. Clinical CurrentSince Jul 22, 2013 Accepting new patients

Locations

3000 Kavanaugh Blvd
Ste 206A
Little Rock, AR 72205
Phone (501) 680-4239

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1679609937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 PINE VALLEY RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722071817",
            "telephone_number": "501-680-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 PINE VALLEY RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722071817",
            "telephone_number": "501-680-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "ERIC",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "PHD, LCSW, CGP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2293-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.