Consulting Psychology of Western Arkansas, Inc.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

90-18P Issued in AR

Legal business name

CONSULTING PSYCHOLOGY OF WESTERN ARKANSAS, INC.

Practice address

1100 S Waldron Rd
Fort Smith, AR 72903-2552

Phone

(479) 785-1995

Fax

(479) 785-4248

NPI assigned

Mar 2, 2011

Last updated

Apr 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patty Jones

Title

Office Manager

Phone

(479) 785-1995

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1912205725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S WALDRON RD STE 206",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032590",
            "telephone_number": "479-785-1995",
            "fax_number": "479-785-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S WALDRON RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032552",
            "telephone_number": "479-785-1995",
            "fax_number": "479-785-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTING PSYCHOLOGY OF WESTERN ARKANSAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-785-1995"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "90-18P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118624719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.