Shaquita M Cornelius, LAC

Individual provider Active NPI Counselor · Dumas, AR

NPI 1801525779 · NPPES record last updated Sep 11, 2026

Key facts

NPI
1801525779
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
License
A2603005 (AR)
Practice address
741 Highway 65 S
Dumas, AR 71639-3003
Phone
(870) 382-4001
Fax
(870) 382-6094
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A2603005 AR Yes

Addresses

Primary practice location

741 Highway 65 S
Dumas, AR 71639-3003

Mailing address

790 Roberts Dr
Monticello, AR 71655-5723
Phone (870) 367-2461

Other providers in Dumas, AR

All providers in Dumas, AR · Counselor in Arkansas

Sources for this page

Verify at the official NPI Registry.