JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES


Address: 2304 W 29th Ave, Pine Bluff, AR 71603-5005
Phone: 8702475222

JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES (NPI# 1013461987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013461987
Entity Type Organization
Organization Name JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES
Practice Address 2304 W 29th Ave
Pine Bluff
AR 71603-5005
Mailing Address Po Box 21203
White Hall
AR 71612-1203
Practice Telephone 8702475222
Practice Fax Number 8706714847
Mailing Telephone 8702475222
Mailing Fax Number 8706714847
Enumeration Date 2016-08-09
Last Update Date 2016-08-09
Authorized Official Name MR. SCOTT AARON MABRY (CLINICAL DIRECTOR)
Authorized Official Telephone 8702475222
Authorized Official Credential CADC, CCS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1700228558 Jefferson Comprehensive Counseling Associates Clinic/Center 2304 W 29th Ave Ste 1&2, Pine Bluff, AR 71603-5005 2013-07-22

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES 2720 W 28th Ave, Pine Bluff, AR 71603-4919

Office Location

Street Address 2304 W 29TH AVE
City PINE BLUFF
State AR
Zip Code 71603-5005

Providers in the same location

NPI Name Taxonomy Address Enumeration
1952546194 Karen Marie Appleget Counselor 2304 W 29th Ave, Pine Bluff, AR 71603-5005 2008-12-02
1538553896 Roger Cameron Counselor 2304 W 29th Ave, Suite 1, Pine Bluff, AR 71603-5005 2015-03-25
1962896217 Madeline Noel Fults Counselor 2304 W 29th Ave, Suite 1, Pine Bluff, AR 71603-5005 2015-03-25
1225422561 Scott Aaron Mabry Counselor 2304 W 29th Ave, Pine Bluff, AR 71603-5005 2015-03-25
1104227586 Dorcas Hope Vangilst Counselor 2304 W 29th Ave, Pine Bluff, AR 71603-5005 2014-09-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1700445038 Hannah Carter Dentist 3801 S Olive St, Pine Bluff, AR 71603 2019-06-11
1821544628 Nauman Yunus Md Pa Internal Medicine 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 2016-08-31
1407278120 Arkansas Cancer Clinic Pa Radiology 7200 South Hazel Street, Pine Bluff, AR 71603 2014-01-15
1730515396 Sharon Yvette Webb Student in an Organized Health Care Education/Training Program 2318 Kyle Street, Pine Bluff, AR 71603 2013-09-16
1477992733 David Larry Byrd Pharmacist 5 Longmeadow, Pine Bluff, AR 71603 2013-06-20
1437400371 Thomas Jordan Harper Pharmacist 2809 South Camden Road, Pine Bluff, AR 71603 2012-10-01
1992080469 C&d Disability.inc Early Intervention Provider Agency 4806 W 9th Street, Pine Bluff, AR 71603 2011-10-17
1457645863 Clifton G Roaf & Marvin Q Caudle Dentist 1310 South Linden Street, Pine Bluff, AR 71603 2011-06-02
1932402682 Mary Campbell Licensed Practical Nurse 2302 W. 28th, Suite A, Pine Bluff, AR 71603 2010-12-17
1245468925 Evan N Newbolt Ophthalmology 3805 West 28th Ave, Pine Bluff, AR 71603 2009-07-01
Find all providers in zip 71603

Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306484860 Eaglecrest Recovery LLC Clinic/Center 1106 Sw 2nd St, Bentonville, AR 72712-5026 2019-12-16
1407407570 Serenity Park Recovery Clinic Clinic/Center 2711 W Roosevelt Rd, Little Rock, AR 72204-5668 2019-09-20
1447723143 Sozo Recovery Centers Inc Clinic/Center 243 Nathan Ter, Jessieville, AR 71949-9289 2019-01-04
1346642634 Addiction & Mental Health Services, LLC Clinic/Center 11215 Hermitage Rd Ste 204, Little Rock, AR 72211-3864 2014-09-18
1942403696 Gateway House Inc Clinic/Center 3900 Armour Avenue, Fort Smith, AR 72904-4317 2007-06-08
1285273219 True Self Recovery LLC Clinic/Center 1104 N 2nd St, Rogers, AR 72756-2834 2019-12-20
1902443229 Quapaw House Clinic/Center 615 W Grand Ave, Hot Springs, AR 71901-3927 2019-12-05
1255977054 University of Arkansas for Medical Sciences Clinic/Center 4224 Shuffield Drive, Little Rock, AR 72205-7101 2019-11-27
1447780952 Arc Rehabilitation Center Pa Clinic/Center 1 Lile Ct Ste 103, Little Rock, AR 72205-6239 2017-06-16

Competitor

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City PINE BLUFF
Zip Code 71603

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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