| Alicyn Crystal Marie Hennis, LPC | |
|
2400 S 48th St, Springdale, AR 72762-6683 | |
| (479) 750-2020 | |
| (479) 750-4843 |
| Full Name | Alicyn Crystal Marie Hennis |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 2400 S 48th St, Springdale, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487692992 | NPI | - | NPPES |
| 5Y579 | Other | AR | BLUE SHIELD PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | P0509058 (Arkansas) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220525002138 |
| Mailing Address | Practice Location Address |
|---|---|
| Alicyn Crystal Marie Hennis, LPC 2400 S 48th St, Springdale, AR 72762-6683 Ph: (479) 750-2020 | Alicyn Crystal Marie Hennis, LPC 2400 S 48th St, Springdale, AR 72762-6683 Ph: (479) 750-2020 |
Brenda Joyce Hill, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2400 S 48th St, Springdale, AR 72762 Phone: 479-750-2020 Fax: 479-750-8967 | |
Leah Nicole Finn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2400 S 48th St, Springdale, AR 72762 Phone: 479-750-2020 Fax: 479-750-8967 | |
Michael Patrick Leonard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2400 S 48th St, Springdale, AR 72762 Phone: 479-750-2020 Fax: 479-750-4843 | |
Alana Nicole Linn, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2400 S 48th St, Springdale, AR 72762 Phone: 479-750-2020 Fax: 479-750-4843 | |
Beverly Ann Treat, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5537 Bleaux Ave, Springdale, AR 72762 Phone: 870-448-4727 Fax: 870-448-4496 | |
Jason Adams, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2400 S 48th St, Springdale, AR 72762 Phone: 479-750-2020 Fax: 479-750-8967 | |
Lance Gregory Johnson, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2400 S 48th St, Springdale, AR 72762 Phone: 479-750-2020 Fax: 479-750-8967 |