Individual provider Active NPI

Jaime L Harness

  • Professional Counselor
  • Conway, AR
National Provider Identifier
1952078503
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P2408003 Issued in AR
Practice address
350 Salem Rd Ste 1
Conway, AR 72034-6166
Phone
(501) 336-8300
NPI assigned
Aug 23, 2021
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X P2408003 AR Primary

Addresses

Primary practice location

350 Salem Rd Ste 1
Conway, AR 72034-6166

Mailing address

2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020

Other identifiers 1

IdentifierTypeStateIssuer
324635719MedicaidAR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240819002206 AR Practitioner - Mental Health Counselor 9931647161 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates, Inc. CurrentSince Aug 2, 2024 Accepting new patients
Counseling Associates Inc CurrentSince Aug 2, 2024 Accepting new patients

Locations

350 Salem Rd
Ste 1
Conway, AR 72034
Phone (501) 336-8300

110 Skyline Dr
Russellville, AR 72801
Phone 4799675570223

2400 S 48th St
Springdale, AR 72762
Phone (479) 725-5115

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1952078503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SALEM RD STE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346166",
            "telephone_number": "501-336-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARNESS",
        "first_name": "JAIME",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P2408003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324635719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.