NPIMap

Organization Active NPI

Arkansas Counseling and Psychodiagnostics, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Arkadelphia, AR
National Provider Identifier
1902060684
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
ARKANSAS COUNSELING AND PSYCHODIAGNOSTICS, INC.
Practice address
2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307
Phone
(870) 230-8217
Fax
(870) 230-8201
NPI assigned
Jul 11, 2008
Last updated
Dec 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Authorized official

Name
Dr. Charles Adolph Weiner II, ED. D. PSYCHOLOGIST
Title
Vice President and Cco
Phone
(870) 230-3404

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307

Mailing address

2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307
Phone (870) 230-8217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140930002778 AR Part B Supplier - Clinic/Group Practice 0446470124 Receives reassigned benefits from 3 practitioners
Practice locations: Arkadelphia, AR; Murfreesboro, AR

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Counseling and Psychodiagnostics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2707 Caddo St
Ste 6
AR 71923

2506 Country Club Rd
Arkadelphia, AR 71923
Phone (870) 230-8217

2707 Caddo St
Ste 6
Arkadelphia, AR 71923
Phone (870) 230-8217

3004 Pine St
Arkadelphia, AR 71923
Phone (870) 230-8217

123 N Washington Ave
Murfreesboro, AR 71958
Phone (870) 285-3699

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 137

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.

View all 137

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1902060684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 CADDO ST STE 6",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235307",
            "telephone_number": "870-230-8217",
            "fax_number": "870-230-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 CADDO ST STE 6",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235307",
            "telephone_number": "870-230-8217",
            "fax_number": "870-230-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS COUNSELING AND PSYCHODIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ADOLPH",
        "authorized_official_title_or_position": "VICE PRESIDENT AND CCO",
        "authorized_official_telephone_number": "870-230-3404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "ED. D. PSYCHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arkadelphia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.