Active NPI
Mary Ann Callison, LPE
- Mental Health Counselor
- Benton, AR
National Provider Identifier
1720129265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 92-5E
- Practice address
- 212 W Sevier Street
Benton, AR 72015 - Phone
- (501) 776-0500
- Fax
- (501) 776-0507
- NPI assigned
- Feb 9, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 92-5E | AR | Primary |
| Mental Health Counselor | 101YM0800X | 92-05 LPE-I | AR |
Addresses
Primary practice location
212 W Sevier Street
Benton, AR 72015
Mailing address
212 W Sevier Street
Benton, AR 72015
Phone (501) 776-0500
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 |
|---|---|---|---|
| 92-05 LPE-I | AR | MD | Mental Health Counselor |
| 92-5E | AR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1720129265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 W SEVIER STREET",
"city": "BENTON",
"state": "AR",
"postal_code": "72015",
"telephone_number": "501-776-0500",
"fax_number": "501-776-0507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 W SEVIER STREET",
"city": "BENTON",
"state": "AR",
"postal_code": "72015",
"telephone_number": "501-776-0500",
"fax_number": "501-776-0507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLISON",
"first_name": "MARY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LPE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "92-5E",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "92-05 LPE-I",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.