Magnolia Mental Health Clinic PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MAGNOLIA MENTAL HEALTH CLINIC PLLC

Practice address

1061 Front St
Conway, AR 72032-4305

Phone

(501) 209-3362

NPI assigned

Nov 7, 2023

Organization subpart

No

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

Authorized official

Name

Alisha McCool, PMHNP

Title

Owner/Pmhnp

Phone

(501) 209-3362

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Arianna Miyoko Bierle

  • Professional Counselor
  • Conway, AR
  • NPI 1780546762
  NPD

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1972376309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 FRONT ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324305",
            "telephone_number": "501-209-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 FRONT ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324305",
            "telephone_number": "501-209-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MENTAL HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCOOL",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "OWNER/PMHNP",
        "authorized_official_telephone_number": "501-209-3362",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366033749",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy A Magbanua
• Magie Mabrey Eye Clinic, P a
• Magie Smith Charton Eye Clinic PA
• Lindsay Marie Magie, OTR/L. MS
• Stephen Kyle Magie, M.D.
• Ashleigh Mahan, CASE MANAGER PARAPRO
• Paula Mainard, LCSW
• Benjamin Kneath Majors
• Pamela Malabanan, CMP
• Mark Andrew Mallett, DDS

• Psychiatric/Mental Health Nurse Practitioner in Conway, AR
• Providers in Conway, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.