Lilli-Anna Baca
Individual provider Active NPI Psychologist · El Dorado, AR
NPI 1831589431 · NPPES record last updated Jan 3, 2023
Key facts
- NPI
- 1831589431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 202116 (AR)
- Practice address
- 715 N College Ave
El Dorado, AR 71730-4403 - Phone
- (870) 862-7921
- Fax
- (870) 864-2490
- NPI assigned
- Feb 3, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Arkansas Regional Health Center | Current |
Accepting new patients | |
| South Arkansas Regional Health Center | Current |
Accepting new patients | |
| Counseling Associates, Inc | Past | Accepting new patients |
Locations
715 N College Ave
El Dorado, AR 71730
Phone (870) 862-7921
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Psychologist | 103T00000X | 202116 | AR | Yes |
Addresses
Primary practice location
715 N College Ave
El Dorado, AR 71730-4403
Mailing address
110 Skyline Dr
Russellville, AR 72801-3362
Phone (479) 968-1298
Other providers in El Dorado, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.