Brody Prince, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P2301005 Issued in AR

Practice address

106 Mountain Place Drive
Mountain View, AR 72560

Phone

(870) 269-4193

Fax

(870) 269-4199

NPI assigned

Sep 13, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Real Development Corporation

  dba RPI Behavioral Health

  • Community/Behavioral Health Agency
  • Russellville, AR
  • NPI 1568943140
  Medicare reassignment NPD
• Enlightened Pathways Counseling

  • Professional Counselor
  • Little Rock, AR
  • NPI 1295527091
  NPD Authorized official

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1770002461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MOUNTAIN PLACE DRIVE",
            "city": "MOUNTAIN VIEW",
            "state": "AR",
            "postal_code": "72560",
            "telephone_number": "870-269-4193",
            "fax_number": "870-269-4199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Gap Rd",
            "address_purpose": "LOCATION",
            "city": "Batesville",
            "state": "AR",
            "postal_code": "725018679",
            "country_code": "US",
            "telephone_number": "18707938900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "BRODY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-13",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1910143",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2301005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Pizell, CMP
• Kristin Poff
• Maria G Polendo, RECOVERY ASSISTANT
• Laken Powell
• Sarah D Presley, RECOVERY ASSISTANT
• Douglas Scott Pringle, PD
• Tammy Raby, RECOVERY ASSISTANT
• Amber Raker-Stevens, RECOVERY ASSISTANT
• Scott Ramsey, RECOVERY ASSISTANT
• Chandra Dejarnette Ransom, LOTR

• Professional Counselor in Mountain View, AR
• Providers in Mountain View, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.