Individual provider Active NPI

Patrena D Tabron, B.A, M.H.P.P.

  • Mental Health Counselor
  • Little Rock, AR
National Provider Identifier
1750590733
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A1603032 Issued in AR
Practice address
4400 Shuffield Dr
Little Rock, AR 72205-7100
Phone
(501) 686-9300
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A1603032 AR Primary

Addresses

Primary practice location

4400 Shuffield Dr
Little Rock, AR 72205-7100

Mailing address

6800 Mabelvale Cut Off
Little Rock, AR 72209-2370
Phone (501) 837-3728

Other identifiers 1

IdentifierTypeStateIssuer
174031795MedicaidAR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240104000331 AR Practitioner - Mental Health Counselor 3870944812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspiration Day Treatment, Inc.Group PAC ID 5698801272, 8 clinicians

Practice addresses (Care Compare)

11700 Kanis Rd
Suite 2
Little Rock, AR 72211-3794
Phone (501) 221-1941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
A1603032ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inspiration Day Treatment, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

11700 Kanis Rd
Ste 2
Little Rock, AR 72211
Phone (501) 221-1941

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1750590733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 MABELVALE CUT OFF",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722092370",
            "telephone_number": "501-837-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 SHUFFIELD DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057100",
            "telephone_number": "501-686-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABRON",
        "first_name": "PATRENA",
        "middle_name": "D",
        "credential": "B.A, M.H.P.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1603032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174031795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.