Organization Active NPI

Phoenixhealthllc

  • Counselor
  • Bentonville, AR
National Provider Identifier
1821957374
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
PHOENIXHEALTHLLC
Practice address
701 NW McNelly Rd Ste 9
Bentonville, AR 72712-9160
Phone
(479) 877-5950
NPI assigned
Jan 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Authorized official

Name
Russell Prause, LPC-SNPI 1417560806
Title
Clinical Director
Phone
(479) 877-5950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

701 NW McNelly Rd Ste 9
Bentonville, AR 72712-9160

Mailing address

701 NW McNelly Rd Ste 9
Bentonville, AR 72712-9160
Phone (479) 877-5950

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1768867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1821957374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NW MCNELLY RD STE 9",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727129160",
            "telephone_number": "479-877-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NW MCNELLY RD STE 9",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727129160",
            "telephone_number": "479-877-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIXHEALTHLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-20",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "PRAUSE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "479-877-5950",
        "authorized_official_credential": "LPC-S"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.