Anna Walker Willoughby, LAC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3201 W Keiser
Osceola, AR 72370-3467

Phone

(870) 622-0592

Fax

(870) 622-0782

NPI assigned

Aug 14, 2018

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 names 1

• Anna Marilyn Willoughby Other name

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Changes Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Wynne, AR
  • NPI 1114260486
  Medicare reassignment NPD

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1700366382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE ROAD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W KEISER",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703467",
            "telephone_number": "870-622-0592",
            "fax_number": "870-622-0782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 W Keiser Ave",
            "address_purpose": "LOCATION",
            "city": "Osceola",
            "state": "AR",
            "postal_code": "723703467",
            "country_code": "US",
            "telephone_number": "870-622-0592",
            "fax_number": "870-622-0782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "ANNA",
        "middle_name": "WALKER",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "WILLOUGHBY",
            "middle_name": "MARILYN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Libby Wilhite, RN
• Charles Williams Jr., MTTPP
• Willis Clinic
• Willis Clinic Express
• Sherita D Willis, MD
• Mark K Wilson, DDS
• Millie Diane Wimberley
• Linda Childers Wright
• Patricia Dolly Wroten, MHPP

• Counselor in Osceola, AR
• Providers in Osceola, AR by specialty
• Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.