Individual provider Active NPI

Kenneth Wayne Robison, LPC

  • Mental Health Counselor
  • Fort Smith, AR
National Provider Identifier
1760076608
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P2102151 Issued in AR
Practice address
1501 S Waldron Rd Ste 102
Fort Smith, AR 72903-2574
Phone
(479) 242-2826
Fax
(479) 242-1975
NPI assigned
Feb 22, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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 P2102151 AR Primary

Addresses

Primary practice location

1501 S Waldron Rd Ste 102
Fort Smith, AR 72903-2574

Mailing address

1501 S Waldron Rd Ste 102
Fort Smith, AR 72903-2574
Phone (479) 242-2826

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

LicenseStateTypeSpecialty
P2102151ARMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1760076608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD STE 102",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-242-2826",
            "fax_number": "479-242-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S WALDRON RD STE 102",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032574",
            "telephone_number": "479-242-2826",
            "fax_number": "479-242-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P2102151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.