Individual provider Active NPI

Mark A Coffman, LPC, LADAC

  • Professional Counselor
  • Russellville, AR
National Provider Identifier
1780775288
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P0505033 Issued in AR
Practice address
902 W Main St
Russellville, AR 72801-3516
Phone
(479) 452-6650
Fax
(479) 452-5847
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P0505033 AR
Professional Counselor 101YP2500X P0505033 AR Primary

Addresses

Primary practice location

902 W Main St
Russellville, AR 72801-3516

Mailing address

PO Box 11818
Fort Smith, AR 72917-1818
Phone (479) 452-6650

Other identifiers 1

IdentifierTypeStateIssuer
227466719MedicaidAR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240307002616 AR Practitioner - Mental Health Counselor 5092151498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Associates IncGroup PAC ID 3173583564, 33 clinicians

Practice addresses (Care Compare)

1021 E Poplar St
Clarksville, AR 72830-4428
Phone (479) 754-8610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P0505033ARMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates Inc CurrentSince Jan 1, 2024 Accepting new patients
Counseling Associates, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1021 E Poplar St
Clarksville, AR 72830
Phone (479) 754-8610

110 Skyline Dr
Russellville, AR 72801
Phone 4799675570223

2400 S 48th St
Springdale, AR 72762
Phone (479) 725-5115

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1780775288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11818",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171818",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013516",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "LPC, LADAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P0505033",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0505033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227466719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.