| Acacia Lynette Johnson, LPC | |
|
104 Lock And Dam Rd, Russellville, AR 72802-9725 | |
| (479) 222-0268 | |
| Not Available |
| Full Name | Acacia Lynette Johnson |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 17 Years |
| Location | 104 Lock And Dam Rd, Russellville, Arkansas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912149618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | P1202014 (Arkansas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Simple Soul Counseling Services, Llc | 6305205329 | 4 |
| Entity Name | Simple Soul Counseling Services, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164144812 PECOS PAC ID: 6305205329 Enrollment ID: O20231028000160 |
| Mailing Address | Practice Location Address |
|---|---|
| Acacia Lynette Johnson, LPC 104 Lock And Dam Rd, Russellville, AR 72802-9725 Ph: (479) 747-5222 | Acacia Lynette Johnson, LPC 104 Lock And Dam Rd, Russellville, AR 72802-9725 Ph: (479) 222-0268 |
Megan Roshawn Ford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Skyline Dr, Russellville, AR 72801 Phone: 479-967-5570 Fax: 479-890-5364 |
Raven Cruz-humberto, Counselor Medicare: Accepting Medicare Assignments Practice Location: 104 Lock And Dam Rd, Russellville, AR 72802 Phone: 479-747-5222 |
Phillip M Higdon, MS LADAC CCS Counselor Medicare: Not Enrolled in Medicare Practice Location: 110 Skyline Drive, Russellville, AR 72801 Phone: 479-968-1298 Fax: 479-968-6053 |
Mary Caitlin Conner, MS, LAC, AADC, LADAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1515 Old Highway 124, Russellville, AR 72802 Phone: 479-264-5299 |
Mrs. Marilyn Jean Mckown, MHPP Counselor Medicare: Accepting Medicare Assignments Practice Location: 1310 W Main St Ste 100, Russellville, AR 72801 Phone: 479-964-2011 |
Matthew Waymack, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1610 S Arkansas Ave, Russellville, AR 72801 Phone: 479-967-4673 Fax: 479-967-7140 |
Theodore Gongola, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3205 W Main St, Russellville, AR 72801 Phone: 479-967-4673 Fax: 479-967-7140 |