MOONBROOK MIND & BODY INTEGRATIVE SERVICES INCORPORATED (NPI# 1376173401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376173401 |
| Entity Type | Organization |
| Organization Name | MOONBROOK MIND & BODY INTEGRATIVE SERVICES INCORPORATED |
| Practice Address |
216 Olive St Texarkana AR 71854-5932 |
| Practice Telephone | 9037085761 |
| Practice Fax Number | 8447065741 |
| Mailing Telephone | 9037085761 |
| Mailing Fax Number | 8447065461 |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |
| Authorized Official Name | JESSICA BENNETT (INCORPORATOR) |
| Authorized Official Telephone | 9037085761 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
216 OLIVE ST |
| City | TEXARKANA |
| State | AR |
| Zip Code | 71854-5932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902219587 | Jessica Bennett | Social Worker | 216 Olive St, Texarkana, AR 71854-5932 | 2014-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962988253 | Holly Renee Snipe | Registered Nurse | 4700 Sunbury Dr, Texarkana, AR 71854 | 2018-07-19 |
| 1023500634 | Carlotta A Powell | Counselor | 7000 N Stateline Ave, Texarkana, AR 71854 | 2018-05-31 |
| 1326538810 | Chad Roldan | Occupational Therapy Assistant | 6402 Countryside Dr, Texarkana, AR 71854 | 2018-05-10 |
| 1649797481 | Alliance Counseling Agency LLC | Community/Behavioral Health | 819 Beech St, Texarkana, AR 71854 | 2017-08-23 |
| 1366971467 | Kimberly Dian Cox | Case Manager/Care Coordinator | 7000 North Stateline Ave, Texarkana, AR 71854 | 2017-06-12 |
| 1295260040 | Seniors for Senior Care | Adult Companion | 4613 Parkway Dr., Texarkana, AR 71854 | 2017-04-28 |
| 1033650635 | Texarkana Eye Associates | Optometrist | 114 East 49th St, Texarkana, AR 71854 | 2017-03-15 |
| 1881064731 | Texarkana Group, P.l.l.c | Chiropractor | 2100 N. State Line Ave., Texarkana, AR 71854 | 2015-10-05 |
| 1528301819 | Megan Guercio | Specialist/Technologist | 1002 East 35th Street, Texarkana, AR 71854 | 2013-04-04 |
| 1831439116 | James Wesley Mcraven | Nurse Practitioner | 210 N. Stateline, Suite 301, Texarkana, AR 71854 | 2013-02-22 |
| Find all providers in zip 71854 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215560529 | Bhg L, LLC | Clinic/Center | 2231 Trinity Blvd, Texarkana, AR 71854-8403 | 2020-02-14 |
| 1841216538 | Texarkana Behavioral Associates, L.c. | Clinic/Center | 701 Arkansas Boulevard, Texarkana, AR 71854 | 2006-07-14 |
| 1508472655 | Samaritan Integrative Services, LLC | Clinic/Center | 4100 Summerhill Rd, Texarkana, TX 75503-2732 | 2020-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113650 | Secure Foundation Counseling Pllc | Clinic/Center | 125 N Fisher St, Jonesboro, AR 72401-2116 | 2020-10-31 |
| 1558979781 | Creoks Mental Health Services, Inc | Clinic/Center | 301 Industrial Road, Mountain View, AR 72560 | 2020-07-14 |
| 1487272670 | Professional Counseling Associates Inc. | Clinic/Center | 977 East Cypress Street, Devalls Bluff, AR 72041 | 2020-07-14 |
| 1740807478 | Brighter Days Counseling and Wellness LLC | Clinic/Center | 100 Commercial Park Ct Apt 108, Maumelle, AR 72113-6986 | 2020-06-29 |
| 1861015745 | Counseling Associates, Inc. | Clinic/Center | 750 Boston St, Danville, AR 72833-7006 | 2020-05-26 |
| 1821610171 | Courageous Journey Psychological Services, LLC | Clinic/Center | 168 Bluefish Ave, Russellville, AR 72802-2407 | 2020-05-09 |
| 1891317293 | Cervantes Counseling Corporation | Clinic/Center | 406 Rena Rd, Van Buren, AR 72956-6507 | 2020-05-08 |
| 1487273199 | Restoring Hope Counseling and Consultation | Clinic/Center | 310 Mid Continent Plz Ste 325, West Memphis, AR 72301-1703 | 2020-04-13 |
| 1922637859 | New Patterns Counseling, LLC | Clinic/Center | 1905 Reveille Cir, Jacksonville, AR 72076-9157 | 2020-04-02 |
| 1417585019 | Positive Place Counseling and Consulting, LLC | Clinic/Center | 807 W 6th Ave, Pine Bluff, AR 71601-4031 | 2020-03-30 |
| Find all providers with the same taxonomy | ||||
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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.