Individual provider Active NPI

Andrea Paige Sumner, LPC

  • Professional Counselor
  • Jacksonville, AR
National Provider Identifier
1780142422
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P2103171 Issued in AR
Practice address
2126 N 1St Street
Suite F
Jacksonville, AR 72076-2868
Phone
(501) 982-5000
Fax
(501) 982-5007
NPI assigned
Mar 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A1901010 AR
Professional Counselor 101YP2500X P2103171 AR Primary

Addresses

Primary practice location

2126 N 1St Street
Suite F
Jacksonville, AR 72076-2868

Mailing address

1815 Pleasant Grove Road
Jonesboro, AR 72405-7870
Phone (870) 933-6886

Other names 1

  • Andrea Burrow Former name

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

LicenseStateTypeSpecialty
A1901010ARMDCounselor
P2103171ARMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1780142422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE ROAD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 N 1ST STREET",
            "address_2": "SUITE F",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720762868",
            "telephone_number": "501-982-5000",
            "fax_number": "501-982-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "ANDREA",
        "middle_name": "PAIGE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A1901010",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2103171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BURROW",
            "credential": "LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.