Individual provider Active NPI

Brenda Crownover, LCSW

  • Clinical Social Worker
  • Benton, AR
National Provider Identifier
1821123274
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
761-C Issued in AR
Practice address
307 E Sevier St
Benton, AR 72015-3934
Phone
(501) 315-4224
Fax
(501) 776-0411
NPI assigned
Feb 23, 2007
Last updated
Apr 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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 761-C AR
Clinical Social Worker 1041C0700X 761-C AR Primary

Addresses

Primary practice location

307 E Sevier St
Benton, AR 72015-3934

Mailing address

307 E Sevier St
Benton, AR 72015-3934
Phone (501) 315-4224

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
I20170210000370 AR Practitioner - Clinical Social Worker 3971886219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Counseling Clinic IncGroup PAC ID 6204885304, 20 clinicians

Practice addresses (Care Compare)

110 Pearson
Benton, AR 72015-4436
Phone (501) 315-4224

310 Whittington Ave
Hot Springs, AR 71901-3406
Phone (501) 623-3477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
761-CARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Clinic, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Counseling Clinic, Inc Clinical CurrentSince Jan 1, 2017 Accepting new patients

Locations

110 Pearson
Benton, AR 72015
Phone (501) 315-4224

112 Pearson
Benton, AR 72015
Phone (501) 315-4224

307 E Sevier St
Benton, AR 72015
Phone (501) 315-4224

310 Whittington Ave
Hot Springs National Park, AR 71901
Phone (501) 623-3477

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1821123274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E SEVIER ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153934",
            "telephone_number": "501-315-4224",
            "fax_number": "501-776-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E SEVIER ST",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153934",
            "telephone_number": "501-315-4224",
            "fax_number": "501-776-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWNOVER",
        "first_name": "BRENDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "761-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "761-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.