CONWAY PSYCHOLOGICAL ASSESSMENT CENTER (NPI# 1255697330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255697330 |
| Entity Type | Organization |
| Organization Name | CONWAY PSYCHOLOGICAL ASSESSMENT CENTER |
| Practice Address |
1210 Hogan Ln Suite 200 Conway AR 72034-8001 |
| Practice Telephone | 5019320255 |
| Practice Fax Number | 5019320258 |
| Mailing Telephone | 5019320255 |
| Mailing Fax Number | 5019320258 |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2012-04-03 |
| Authorized Official Name | DR. KIM DIELMANN (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 5019320255 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 07-27P | AR | Behavioral Health & Social Service Providers |
| Street Address |
1210 HOGAN LN SUITE 200 |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-8001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396092474 | Iryna Kasi | Psychologist | 1210 Hogan Ln, Suite 200, Conway, AR 72034-8001 | 2012-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629426770 | Nicholas Mitrani | Psychologist | 4206 Prince Street, Conway, AR 72034-9398 | 2016-05-31 |
| 1851667349 | Melissa Moix | Psychologist | 1210 Hogan Ln Ste 200, Conway, AR 72034-8063 | 2012-03-28 |
| 1255564803 | Chrystal Lynne Johnston | Psychologist | 710 S Country Club Rd, Conway, AR 72034-9307 | 2009-08-31 |
| 1184752495 | Jennie May Cassidy | Psychologist | 204 University Blvd., Coastal Carolina University, Conway, SC 29528-6054 | 2007-02-28 |
| 1265527238 | William Edward Siegel | Psychologist | 3135 Tyler St, Conway, AR 72034-3456 | 2006-10-04 |
| 1336241223 | William Tadashi Nagahiro | Psychologist | 30 Pleasant St, Conway, NH 03818-2265 | 2006-09-02 |
| 1083716021 | Susan E Schaefer | Psychologist | 350 Salem Road, Suite 1, Conway, AR 72034 | 2006-09-01 |
| 1114578903 | Sarah Lindeman Root | Psychologist | 1100 Bob Courtway Dr Ste 9, Conway, AR 72032-4767 | 2019-09-24 |
| 1770082349 | Samantha Bellini | Psychologist | 81 Washington St, Conway, NH 03818 | 2018-02-08 |
| 1477965374 | Lori Dunaway | Psychologist | 1014 Main St, Conway, AR 72032-5426 | 2014-05-27 |
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| 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.