Ashley Donaldson Wysocki, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6439-C Issued in AR

Practice address

1101 Morgan St
Suite 8
Paragould, AR 72450-3949

Phone

(870) 335-9483

Fax

(870) 335-9487

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ashley Donaldson Withrow Former name

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

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Families, Inc of ArkansasGroup PAC ID 9335133669, 44 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.

• Families, Inc of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jonesboro, AR
  • NPI 1770535569
  Medicare reassignment Care Compare group NPD
• Families, Inc. of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pocahontas, AR
  • NPI 1275623035
  NPD (past)
• Families, Inc. of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paragould, AR
  • NPI 1386728681
  NPD (past)

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1922395870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MORGAN ST",
            "address_2": "SUITE 8",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724503949",
            "telephone_number": "870-335-9483",
            "fax_number": "870-335-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCKI",
        "first_name": "ASHLEY",
        "middle_name": "DONALDSON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6439-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183586795",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5MM24",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "WITHROW",
            "middle_name": "DONALDSON",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey Nicole Wright, LMT
• John Robert Wyatt Jr., CRNA
• Lacey Shayann Wyatt, A.P.N.
• Miranda Wyatt
• Amy M Wynn, APRN, FNP-BC
• Daniel Elliot Wysocki, LPE-I
• Tyler Mirann Wyss, MHPP
• Tai Soumphane Xoumphonephackdy
• James Justin Yancey, M.D.
• Yates Anesthesia, PA

• Clinical Social Worker in Paragould, AR
• Providers in Paragould, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.