Amber Callaway, LPC
Individual provider Active NPI Mental Health Counselor · Fordyce, AR
NPI 1982922035 · NPPES record last updated Sep 6, 2023
Key facts
- NPI
- 1982922035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- P1603041 (AR)
- Practice address
- 300 N Clifton St
Fordyce, AR 71742-3055 - Phone
- (870) 352-5122
- Fax
- (870) 352-5127
- NPI assigned
- May 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231213002293 | AR | Practitioner - Mental Health Counselor | 1850740630 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Mental Health | Current |
Accepting new patients |
| Lumina Revenue Cycle Management LLC | Current |
Accepting new patients | |
| BHC Pinnacle Pointe Healthcare | Past |
Accepting new patients | |
| BHC Pinnacle Pointe Hospital, Inc. | Past | Accepting new patients |
Locations
4301 S 16th St
Fort Smith, AR 72901
Phone (479) 242-1003
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P1603041 | AR | Yes |
Addresses
Primary practice location
300 N Clifton St
Fordyce, AR 71742-3055
Mailing address
300 N Clifton St
Fordyce, AR 71742-3055
Phone (870) 352-5122
Other providers in Fordyce, AR
- Jennifer Lynn Brown
- Stacey Brunson
- Daniel Nathan Bryant
- Jenna Bryant
- Tavante Calhoun
- Leslie Marie Cates
- Cynthia Cayton
- Central Ambulance & Medical Services Inc
- Charles E Kauffman Jr DDS
- Elizabeth Jean Coates
All providers in Fordyce, AR · Mental Health Counselor in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.