NPIMap

Organization Active NPI

Lead Teach Mentor, LLC

Doing business as Thriveworks Conway

  • Professional Counselor
  • Conway, AR
National Provider Identifier
1851702724
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LEAD TEACH MENTOR, LLC
Doing business as
Thriveworks Conway
Practice address
575 Club LN
Suite 103
Conway, AR 72034-3681
Phone
(501) 745-6644
NPI assigned
May 14, 2014
Last updated
May 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Authorized official

Name
Curtis Robinson
Title
Office Manager
Phone
(501) 745-6644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

575 Club LN
Suite 103
Conway, AR 72034-3681

Mailing address

1059 Vista Park Dr
Suite B
Forest, VA 24551-4253

Other names 1

  • Thriveworks Conway Doing business as

National Provider Directory

National Provider Directory

Locations

575 Club Ln
Ste 103
Conway, AR 72034
Phone (501) 404-9737

102 Country Club Pkwy
Maumelle, AR 72113
Phone (501) 404-9737

1059 Vista Park Dr
Ste B
Forest, VA 24551

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1851702724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 VISTA PARK DR",
            "address_2": "SUITE B",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245514253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 CLUB LN",
            "address_2": "SUITE 103",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343681",
            "telephone_number": "501-745-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAD TEACH MENTOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "501-745-6644"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thriveworks Conway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.