| Miss Carissa Jennie Gill, LPC | |
|
10025 W. Markham Street, Ste 210, Little Rock, AR 72205-2178 | |
| (501) 663-5473 | |
| (501) 801-1816 |
| Full Name | Miss Carissa Jennie Gill |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 10025 W. Markham Street, Little Rock, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053786004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | A1511157 (Arkansas) | Secondary |
| 101YP2500X | Counselor - Professional | P2006022 (Arkansas) | Primary |
| Entity Name | Living Hope Southeast, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689877862 PECOS PAC ID: 3072605831 Enrollment ID: O20070823001023 |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Carissa Jennie Gill, LPC 10025 W. Markham Street, Ste 210, Little Rock, AR 72205-2178 Ph: (501) 663-5473 | Miss Carissa Jennie Gill, LPC 10025 W. Markham Street, Ste 210, Little Rock, AR 72205-2178 Ph: (501) 663-5473 |
Charlie Simpson Iii, LAMFT, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4 Shackleford Plz Ste 100, Little Rock, AR 72211 Phone: 501-313-1185 | |
Crystal Ann Mcmullen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5918 Lee Ave, Little Rock, AR 72205 Phone: 501-669-2199 | |
Colleen Stone, MHPP Counselor Medicare: Not Enrolled in Medicare Practice Location: 20400 Col Glenn Rd, Little Rock, AR 72210 Phone: 501-821-5500 | |
Mrs. Adrienne Reeves, L.P.E. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1900 Aldersgate Rd, Little Rock, AR 72205 Phone: 501-821-5459 Fax: 501-821-6116 | |
David Laser Jr., BS, MBA, CIT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3700 W 65th St, Little Rock, AR 72209 Phone: 479-806-0469 | |
Crystal Goins, QBHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 20400 Colonel Glenn Rd, Little Rock, AR 72210 Phone: 501-821-5500 | |
Abigail Campbell, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Lile Ct Ste 200, Little Rock, AR 72205 Phone: 479-964-2011 |