Clarence Kevin Bedford, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1003022 Issued in AR

Practice address

204 S 24TH St
Rogers, AR 72758-1129

Phone

(479) 621-0301

Fax

(479) 899-6300

NPI assigned

Sep 9, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

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 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

PT Concepts PLLCGroup PAC ID 1951669852, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• PT Concepts, PLLC

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1164931291

  AR, Professional

  Medicare reassignment Care Compare group NPD
• My Therapy LLC

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1598633091
  NPD (past)
• Ozark Guidance Center, Inc

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1659945194
  NPD (past)

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1922331925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S 24TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581129",
            "telephone_number": "479-621-0301",
            "fax_number": "479-899-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S 24TH ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581129",
            "telephone_number": "479-621-0301",
            "fax_number": "479-899-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Walnut St Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727563524",
            "country_code": "US",
            "telephone_number": "479-621-0301",
            "fax_number": "479-899-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 W Walnut St Ste 1400",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727563598",
            "country_code": "US",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-8967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEDFORD",
        "first_name": "CLARENCE",
        "middle_name": "KEVIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "P1003022",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1003022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR LICENSE",
            "identifier": "P1003022",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Beavers
• Terrell Beavers, P.D.
• Jon Beckman, PT, DPT
• Cheryl Anne Beckwith, COTA/L
• Rachel Louella Beckwith, MS, CCC-SLP
• Amy Bedwell, LMT
• Alex Christopher Bell, O.D.
• Austin Patrick Bell, M.D.
• Darin Bell, O.T.
• Kylee Bell

• All providers in Rogers, AR
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.