Active NPI
Mary Lisa Kessler, LCSW
- Clinical Social Worker
- Springdale, AR
National Provider Identifier
1760626154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4605-C
- Practice address
- 2400 S 48TH Street
Springdale, AR 72762 - Phone
- (479) 750-2020
- Fax
- (479) 750-8967
- NPI assigned
- Apr 29, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-06098 | NM | |
| Clinical Social Worker | 1041C0700X | 4605-C | AR | Primary |
Addresses
Primary practice location
2400 S 48TH Street
Springdale, AR 72762
Mailing address
2400 S 48TH Street
Springdale, AR 72762
Phone (479) 750-2020
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-06098 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1760626154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 S 48TH STREET",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "72762",
"telephone_number": "479-750-2020",
"fax_number": "479-750-8967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 S 48TH STREET",
"city": "SPRINGDALE",
"state": "AR",
"postal_code": "72762",
"telephone_number": "479-750-2020",
"fax_number": "479-750-8967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KESSLER",
"first_name": "MARY",
"middle_name": "LISA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-29",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-06098",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "4605-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springdale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.