Active NPI
Angela Etchison, M.S.
- Mental Health Counselor
- Little Rock, AR
National Provider Identifier
1801048939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 05-06EI
- Practice address
- 13024 Stacy LN
Little Rock, AR 72211-3239 - Phone
- (501) 868-4900
- Fax
- (501) 868-4901
- NPI assigned
- Oct 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 05-06EI | AR | Primary |
Addresses
Primary practice location
13024 Stacy LN
Little Rock, AR 72211-3239
Mailing address
13024 Stacy LN
Little Rock, AR 72211-3239
Phone (501) 868-4900
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-06EI | AR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1801048939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13024 STACY LN",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722113239",
"telephone_number": "501-868-4900",
"fax_number": "501-868-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13024 STACY LN",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722113239",
"telephone_number": "501-868-4900",
"fax_number": "501-868-4901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETCHISON",
"first_name": "ANGELA",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "05-06EI",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.