Michelle Ainsworth, LAC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

A0910109 Issued in AR

Practice address

1615 MLK Blvd
Malvern, AR 72104-2233

Phone

(501) 332-5236

Fax

(501) 620-5109

NPI assigned

Mar 5, 2007

Last updated

Dec 11, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellspring Renewal CenterGroup PAC ID 1254778897, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellspring Renewal Center

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1053833939
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292025600000",
    "number": "1851420764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DONS WAY",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136478",
            "telephone_number": "501-624-7111",
            "fax_number": "501-620-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MLK BLVD",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042233",
            "telephone_number": "501-332-5236",
            "fax_number": "501-620-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AINSWORTH",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2010-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A0910109",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116399726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Access Medical Clinic Arkansas LTC LLC
• Access Medical Clinic Arkansas LTC LLC
• Luke Adams, CMP
• Kera Beth Addison, MS, OTR/L
• Laquita Aings
• Alternative Opportunities (Dayspring Behavioral Health of Malvern)
• Joy C Amason
• Amber McCrackin LLC
• Marquel Amos
• Amy Neighbors, LPC, LLC

• Counselor in Malvern, AR
• Providers in Malvern, AR by specialty
• Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.