Micah Counseling, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MICAH COUNSELING, LLC

Practice address

128 Southwinds Rd Ste 5
Farmington, AR 72730-8678

Phone

(870) 270-9877

NPI assigned

Dec 11, 2021

Organization subpart

No

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

Authorized official

Name

Chelsie Kennedy, LCSWNPI 1366961658

Title

Licensed Certified Social Worker

Phone

(870) 270-9877

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chelsie E Kennedy

  • Social Worker
  • Fayetteville, AR
  • NPI 1366961658
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1639180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639180800000",
    "number": "1689333171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 SOUTHWINDS RD STE 5",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308678",
            "telephone_number": "870-270-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 SOUTHWINDS RD STE 5",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308678",
            "telephone_number": "870-270-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICAH COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-11",
        "last_updated": "2021-12-11",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "CHELSIE",
        "authorized_official_title_or_position": "LICENSED CERTIFIED SOCIAL WORKER",
        "authorized_official_telephone_number": "870-270-9877",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tkeyah McDaniel
• Brittanee Layne McGarrah
• Zoe Loretta Allgood McGee, CCC-SLP
• Tiffany Hale McKinney
• Ashlyn Brianna Mero, COTA
• Charles R Mills, MD
• Tatrecia Moss
• Grant Mullins
• Desiree R Nelson, APRN
• Northwest Ar Esc

• Mental Health Clinic/Center (Including Community Mental Health Center) in Farmington, AR
• Providers in Farmington, AR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2021; 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.