Individual provider Active NPI

Lillian Marshall, LCSW

  • Clinical Social Worker
  • Pine Bluff, AR
National Provider Identifier
1851648976
Registry record updated Dec 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2357C Issued in AR
Practice address
2500 Rike Dr
Pine Bluff, AR 71603-3937
Phone
(870) 534-1834
Fax
(870) 534-5798
NPI assigned
Aug 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2357C AR Primary

Addresses

Primary practice location

2500 Rike Dr
Pine Bluff, AR 71603-3937

Mailing address

2500 Rike Dr
Pine Bluff, AR 71603-3937
Phone (870) 534-1834

Other identifiers 1

IdentifierTypeStateIssuer
116378726MedicaidAR

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
I20130211000292 AR Practitioner - Clinical Social Worker 0648424150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Arkansas Behavioral Healthcare System Inc 16 clinicians

Practice addresses (Care Compare)

2500 Rike Dr
Pine Bluff, AR 71603-3937
Phone (870) 534-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Arkansas Behavioral Healthcare System Inc CurrentSince Dec 10, 2012 Accepting new patients

Locations

2500 Rike Dr
Pine Bluff, AR 71603
Phone (870) 534-1834

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1851648976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 RIKE DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716033937",
            "telephone_number": "870-534-1834",
            "fax_number": "870-534-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 RIKE DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716033937",
            "telephone_number": "870-534-1834",
            "fax_number": "870-534-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "LILLIAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2357C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116378726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.