Active NPI
Robert M Streett, LCSW
- Clinical Social Worker
- Mountain Home, AR
National Provider Identifier
1780765768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1768C
- Practice address
- 706 S Main St
Suite 1
Mountain Home, AR 72653-4417 - Phone
- (870) 425-5644
- Fax
- (870) 424-2201
- NPI assigned
- Oct 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1768C | AR | Primary |
Addresses
Primary practice location
706 S Main St
Suite 1
Mountain Home, AR 72653-4417
Mailing address
2153 E Joyce Blvd
Suite 201
Fayetteville, AR 72703-4714
Phone (479) 575-9471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55048 | Other | MEDICARE ID NUMBER |
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 |
|---|---|---|---|
| 1768C | AR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Counseling Services Inc | Past | Accepting new patients | |
| Alternative Oppurtunities | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Health Resources of Arkansas
- Case Management Agency
- Batesville, AR
- NPI 1720063779
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Mountain Home, AR
- NPI 1043266315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262649600000",
"number": "1780765768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2153 E JOYCE BLVD",
"address_2": "SUITE 201",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034714",
"telephone_number": "479-575-9471",
"fax_number": "479-587-9392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 S MAIN ST",
"address_2": "SUITE 1",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726534417",
"telephone_number": "870-425-5644",
"fax_number": "870-424-2201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STREETT",
"first_name": "ROBERT",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-18",
"last_updated": "2010-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "1768C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID NUMBER",
"identifier": "55048",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.