Grace Therapeutics of Arkansas

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

GRACE THERAPEUTICS OF ARKANSAS

Practice address

1912 Washington Ave
Conway, AR 72032-2729

Phone

(870) 623-6299

NPI assigned

Sep 15, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Clevelon Lasker, LPCNPI 1821743105

Title

Owner

Phone

(870) 623-6299

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Channing Hall, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Conway, AR
  • NPI 1104464445

  Single Specialty

  Medicare reassignment NPD
• Clevelon Lasker, LPC

  • Mental Health Counselor
  • Conway, AR
  • NPI 1821743105
  NPD Authorized official

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1821710955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 WASHINGTON AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720322729",
            "telephone_number": "870-623-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 WASHINGTON AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720322729",
            "telephone_number": "870-623-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE THERAPEUTICS OF ARKANSAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "LASKER",
        "authorized_official_first_name": "CLEVELON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-623-6299",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.therapynotes.com/",
            "affiliation": "N",
            "endpointDescription": "Secure therapy system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1912 Washington Ave",
            "city": "Conway",
            "state": "AR",
            "country_code": "US",
            "postal_code": "720322729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Glenda Darlene Gore, FNP-BC
• Quincy Goree, RECOVERY ASSISTANT
• Laura Gottsponer
• Kayla Gowin, LAC
• Arianna Maria Goyer
• Candice Lauren Grady, PT, DPT
• Kristy L Grady
• Morgan Graham, LPC
• Tyler Lee Graham, PT
• Malcolm Grant

• Mental Health Counselor in Conway, AR
• Providers in Conway, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.