Individual provider Active NPI

Elsbeth Anne Fast, MSW, LCSW

  • Clinical Social Worker
  • Fayetteville, AR
National Provider Identifier
1720235013
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7435-C Issued in AR
Practice address
240 N Block Ave Ste 306
Fayetteville, AR 72701-5205
Phone
(479) 879-7956
NPI assigned
Aug 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7435-C AR Primary

Addresses

Primary practice location

240 N Block Ave Ste 306
Fayetteville, AR 72701-5205

Mailing address

240 N Block Ave Ste 306
Fayetteville, AR 72701-5205
Phone (479) 879-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 16, 2024 through Jan 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7435-CARMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1720235013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N BLOCK AVE STE 306",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015205",
            "telephone_number": "479-879-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N BLOCK AVE STE 306",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727015205",
            "telephone_number": "479-879-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAST",
        "first_name": "ELSBETH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7435-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.