Individual provider Active NPI

Stephanie E Steele-Wren, PSY.D.

  • Psychologist
  • Bentonville, AR
National Provider Identifier
1881019867
Registry record updated Aug 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
202154 Issued in AR
Practice address
809 SE 28TH St Ste 1
Bentonville, AR 72712-4268
Phone
(338) 779-9675
NPI assigned
Feb 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10542 MA
Psychologist 103T00000X 202154 AR Primary

Addresses

Primary practice location

809 SE 28TH St Ste 1
Bentonville, AR 72712-4268

Mailing address

809 SE 28TH St
Ste 1
Bentonville, AR 72712-4268
Phone (833) 779-9675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220826002595 AR Practitioner - Psychologist Billing Independently 8123402096 Reassigns benefits to 1 organization
I20221207001489 AR Practitioner - Clinical Psychologist 8123402096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10542MAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychologyworks, PLLC Psychologist CurrentSince Mar 4, 2022 Accepting new patients
Teladoc Health Medical Group, P.a. Counselor Current Accepting new patients

Locations

3401 SE Macy Rd
Ste 13
Bentonville, AR 72712
Phone (479) 348-5073

809 SE 28th St
#1
Bentonville, AR 72712
Phone (479) 657-8100

Interoperability endpoints

  • Direct secure messaging: stephaniesteelewren@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1881019867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 SE 28TH ST",
            "address_2": "STE 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124268",
            "telephone_number": "833-779-9675",
            "fax_number": "833-779-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 SE 28TH ST STE 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124268",
            "telephone_number": "338-779-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEELE-WREN",
        "first_name": "STEPHANIE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MA",
            "license": "10542",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "202154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.