Active NPI
Misty L Winters, LCSW
- Clinical Social Worker
- Lake Village, AR
National Provider Identifier
1962515841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2458-C
- Practice address
- 1127 Second St
Lake Village, AR 71653-1541 - Phone
- (870) 265-3808
- Fax
- (870) 265-2733
- NPI assigned
- Aug 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2458-C | AR | Primary |
| Social Worker | 104100000X | 1962-M | AR |
Addresses
Primary practice location
1127 Second St
Lake Village, AR 71653-1541
Mailing address
1127 Second St
Lake Village, AR 71653-1541
Phone (870) 265-3808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 169134795 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1962-M | AR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266278400000",
"number": "1962515841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1127 SECOND ST",
"city": "LAKE VILLAGE",
"state": "AR",
"postal_code": "716531541",
"telephone_number": "870-265-3808",
"fax_number": "870-265-2733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 SECOND ST",
"city": "LAKE VILLAGE",
"state": "AR",
"postal_code": "716531541",
"telephone_number": "870-265-3808",
"fax_number": "870-265-2733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINTERS",
"first_name": "MISTY",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2010-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "2458-C",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "1962-M",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "169134795",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Village, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.