Individual provider Active NPI

Mollie F Teas, LPE

  • Counselor
  • Conway, AR
National Provider Identifier
1881373769
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
05-10E Issued in AR
Practice address
1422 Caldwell St Ste M
Conway, AR 72034-5319
Phone
(501) 358-6396
Fax
(501) 588-0484
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 05-10E AR Primary

Addresses

Primary practice location

1422 Caldwell St Ste M
Conway, AR 72034-5319

Mailing address

317 Oak St Ste 3
Conway, AR 72032-5679
Phone (501) 358-6396

Other practice location 1

317 Oak St Ste 3
Conway, AR 72032-5679
Phone (501) 358-6396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05-10EARMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Assessment Center, LLC CurrentSince Jul 23, 2023 Accepting new patients
Therapy Assessment Center LLC CurrentSince Jul 21, 2024 Accepting new patients

Locations

317 Oak St
Ste 3
Conway, AR 72032
Phone (501) 291-3091

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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1881373769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 OAK ST STE 3",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325679",
            "telephone_number": "501-358-6396",
            "fax_number": "501-588-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 CALDWELL ST STE M",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720345319",
            "telephone_number": "501-358-6396",
            "fax_number": "501-588-0484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Oak St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720325679",
            "country_code": "US",
            "telephone_number": "501-358-6396",
            "fax_number": "501-588-0484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEAS",
        "first_name": "MOLLIE",
        "middle_name": "F",
        "credential": "LPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "05-10E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 17, 2023; 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.