NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER (NPI# 1699926154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699926154 |
| Entity Type | Organization |
| Organization Name | NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER |
| Other Organization Name | MID SOUTH HEALTH SYSTEMS, INC. |
| Practice Address |
3700 Access Road Jonesboro AR 72401-7238 |
| Mailing Address |
2707 Browns Ln Jonesboro AR 72401-7213 |
| Practice Telephone | 8709724000 |
| Practice Fax Number | 8709724911 |
| Mailing Telephone | 8709724000 |
| Mailing Fax Number | 8709724911 |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | CARLA JONES (OFFICE MANAGER) |
| Authorized Official Telephone | 8709724000 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 172108526 | 05 |
| Other Name | Type Code |
|---|---|
| Mid South Health Systems, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588957476 | Northeast Arkansas Community Mental Health Center | Counselor | 661 Addison Dr., Wynne, AR 72396 | 2011-05-25 |
| 1770803090 | Northeast Arkansas Community Mental Health Center | Counselor | 211 Missouri, Helena, AR 72342-3707 | 2010-06-09 |
| 1326299736 | Northeast Arkansas Community Mental Health Center | Counselor | 102 South Larkspur, Walnut Ridge, AR 72476-1736 | 2008-10-03 |
| 1598916918 | Northeast Arkansas Community Mental Health Center | Counselor | 2560 Old County Rd, Pocahontas, AR 72455-4118 | 2008-10-03 |
| 1104077676 | Northeast Arkansas Community Mental Health Center | Counselor | 602 David St, Corning, AR 72422-7268 | 2008-10-02 |
| 1275784746 | Northeast Arkansas Community Mental Health Center | Counselor | 1011 W Morgan St, Paragould, AR 72450-2850 | 2008-10-02 |
| 1225321110 | Northeast Arkansas Community Mental Health Center | Counselor | 444 Atkins Blvd, Marianna, AR 72360-2110 | 2011-05-25 |
| 1699068585 | Northeast Arkansas Community Mental Health Center | Counselor | 801 Newman Dr, Helena, AR 72342-8950 | 2011-05-25 |
| 1598058489 | Northeast Arkansas Community Mental Health Center | Counselor | 905 N 7th St, West Memphis, AR 72301-2001 | 2011-05-25 |
| 1396038287 | Northeast Arkansas Community Mental Health Center | Counselor | 28 Southpointe Dr, Paragould, AR 72450-6238 | 2011-05-25 |
| Street Address |
3700 ACCESS ROAD |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-7238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669019634 | Holland Victoria Wagner | Social Worker | 3700 Access Road, Jonesboro, AR 72401 | 2019-12-09 |
| 1023655024 | Mallory Brooke Manley | Registered Nurse | 3700 Access Road, Jonesboro, AR 72401 | 2019-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619523925 | Tarr Personal Care Home LLC. | Community/Behavioral Health | 1180 Mundys Mill Rd, Jonesboro, GA 30238-6038 | 2019-08-13 |
| 1548741713 | Chance of Change, Inc | Community/Behavioral Health | 1489 Mundys Mill Rd Ste 200, Jonesboro, GA 30238-6026 | 2018-08-27 |
| 1255874566 | Andrew J. Nelson, LLC | Community/Behavioral Health | 741 Barnesdale Dr, Jonesboro, GA 30236-1801 | 2016-11-18 |
| 1528513538 | Building A Strong Foundation Consultant Service LLC | Community/Behavioral Health | 7301 Howard Cir, Jonesboro, GA 30236-1940 | 2016-08-19 |
| 1184045163 | Diane Johnson | Community/Behavioral Health | 1141 Gable Terrace, Jonesboro, GA 30236 | 2013-12-18 |
| 1659712180 | Business Management Consulting,llc | Community/Behavioral Health | 2469 Mead Ct, Jonesboro, GA 30236-9209 | 2013-07-12 |
| 1568806412 | Sherman Support and Solutions, LLC | Community/Behavioral Health | 259 Arrowhead Blvd Ste C1, Jonesboro, GA 30236-1167 | 2013-04-23 |
| 1023371416 | Youth Generation Inc | Community/Behavioral Health | 525 Sunnyhill Dr, Jonesboro, GA 30238-4862 | 2012-06-20 |
| 1851651426 | Tlc Family Life Center, LLC | Community/Behavioral Health | 145b N Main St, Jonesboro, GA 30236-3568 | 2012-05-16 |
| 1780957167 | Nu Beginnings | Community/Behavioral Health | 754 Chapman St, Jonesboro, GA 30238-5682 | 2012-02-16 |
| Find all providers in JONESBORO | ||||
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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.