Active NPI
Heather K Bryan, LPC
- Professional Counselor
- Jonesboro, AR
National Provider Identifier
1689823023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P1409067
- Practice address
- 2912 King St
Jonesboro, AR 72401-5321 - Phone
- (870) 586-6743
- NPI assigned
- Sep 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P1409067 | AR | Primary |
Addresses
Primary practice location
2912 King St
Jonesboro, AR 72401-5321
Mailing address
361 Southwest Dr # 190
Jonesboro, AR 72401-5854
Phone (870) 586-6743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1409067 | AR | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wise Mind Counseling PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1689823023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "361 SOUTHWEST DR # 190",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724015854",
"telephone_number": "870-586-6743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2912 KING ST",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724015321",
"telephone_number": "870-586-6743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "HEATHER",
"middle_name": "K",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-10",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1409067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.