Vetcentric Mental Health Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2463-C Issued in AR

Legal business name

VETCENTRIC MENTAL HEALTH SERVICES

Practice address

128 Southwinds Rd Ste 5
Farmington, AR 72730-8652

Phone

(479) 267-6934

Fax

(866) 798-3345

NPI assigned

Mar 27, 2018

Organization subpart

No

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

Authorized official

Name

Kateri B. Killman, LCSW

Title

Therapist

Phone

(479) 599-9385

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1770088338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17682 RIDGEWAY LN",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727615260",
            "telephone_number": "479-599-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 SOUTHWINDS RD STE 5",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308652",
            "telephone_number": "479-267-6934",
            "fax_number": "866-798-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VETCENTRIC MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "KILLMAN",
        "authorized_official_first_name": "KATERI",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "479-599-9385",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2463-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Walmart Inc.
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• Victoria Wehunt

• Clinical Social Worker in Farmington, AR
• Providers in Farmington, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.