Active NPI
Kenneth Joe Heard, LPC
- Professional Counselor
- Bryant, AR
National Provider Identifier
1982776936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P8012118
- Practice address
- 4717 Boone Rd
Bryant, AR 72022-6218 - Phone
- (501) 847-0008
- Fax
- (501) 776-2246
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | P8012118 | AR | Primary |
Addresses
Primary practice location
4717 Boone Rd
Bryant, AR 72022-6218
Mailing address
3616 Independence Dr
Bryant, AR 72022-7025
Phone (501) 231-6166
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240202001099 | AR | Practitioner - Mental Health Counselor | 5698128957 | Practice locations: Bryant, AR |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4717 Boone Rd
Bryant, AR 72022-6218
Phone (501) 231-6166
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P8012118 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383868800000",
"number": "1982776936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3616 INDEPENDENCE DR",
"city": "BRYANT",
"state": "AR",
"postal_code": "720227025",
"telephone_number": "501-231-6166",
"fax_number": "501-847-0008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4717 BOONE RD",
"city": "BRYANT",
"state": "AR",
"postal_code": "720226218",
"telephone_number": "501-847-0008",
"fax_number": "501-776-2246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEARD",
"first_name": "KENNETH",
"middle_name": "JOE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2013-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P8012118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryant, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.