Stephanie Ellis
Individual provider Active NPI Counselor · Trumann, AR
NPI 1922482124 · NPPES record last updated Jul 17, 2015
Key facts
- NPI
- 1922482124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 339 Highway 463 N
Trumann, AR 72472-3505 - Phone
- (870) 483-7039
- Fax
- (870) 483-0590
- NPI assigned
- Jul 17, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
339 Highway 463 N
Trumann, AR 72472-3505
Mailing address
602 N Walton Blvd
Bentonville, AR 72712-4576
Phone (479) 464-1060
Other providers in Trumann, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.