Shannon Roberts

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A2308017 Issued in AR

Practice address

2705A Oak LN
Van Buren, AR 72956-4816

Phone

(479) 452-6650

Fax

(479) 452-5847

NPI assigned

Jan 31, 2024

Last updated

Feb 26, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Central Arkansas Group Counseling, PLLC

  dba Arkansas Counseling and Wellness Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bentonville, AR
  • NPI 1356867303
  NPD (past)

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1972366235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 S 70TH ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035017",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705A OAK LN",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729564816",
            "telephone_number": "479-452-6650",
            "fax_number": "479-452-5847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2308017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River Dental Van Buren PLLC
• River Valley Compounding Pharmacy
• River Valley Medical Clinic
• River Valley Pharmacy, LLC
• Kandy Marie Robbins
• Debra Robinson, SLP
• Rodney Neighbors Counseling LLC
• Leah Rogers
• Melissa Stacey Romero, CNP
• Davina Roper, MS, CCC-SLP

• Mental Health Counselor in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.