NPIMap

Organization Active NPI

Jefferson Comprehensive Counseling Associates

  • Mental Health Counselor
  • Pine Bluff, AR
National Provider Identifier
1700228558
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES
Practice address
2720 W 28TH Ave
Pine Bluff, AR 71603-4919
Phone
(870) 247-5222
Fax
(870) 671-4847
NPI assigned
Jul 22, 2013
Last updated
Jan 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Authorized official

Name
Cherish E Billingsley
Title
Administrative Director
Phone
(870) 247-5222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X P1211108 AR
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2720 W 28TH Ave
Pine Bluff, AR 71603-4919

Mailing address

PO Box 21203
White Hall, AR 71612-1203
Phone (870) 247-5222

Other practice location 1

1100 N University Ave Ste 255
Little Rock, AR 72207-6367
Phone (501) 319-7911

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Comprehensive Counseling Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1100 N University Ave
Ste 255
Little Rock, AR 72207
Phone (501) 319-7911

2720 W 28th Ave
Pine Bluff, AR 71603
Phone (870) 247-5222

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610496000000",
    "number": "1700228558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21203",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716121203",
            "telephone_number": "870-247-5222",
            "fax_number": "870-247-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 W 28TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716034919",
            "telephone_number": "870-247-5222",
            "fax_number": "870-671-4847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N University Ave Ste 255",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722076367",
            "country_code": "US",
            "telephone_number": "501-319-7911",
            "fax_number": "501-319-7921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "BILLINGSLEY",
        "authorized_official_first_name": "CHERISH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "870-247-5222"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AR",
            "license": "P1211108",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.