| Capps Wellness Clinic And Associates, Inc. | |
|
623 S Pine St Harrison AR 72601-5827 | |
| (501) 278-6688 | |
| (870) 204-5306 |
| Full Name | Capps Wellness Clinic And Associates, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 623 S Pine St, Harrison, Arkansas |
| Authorized Official Name and Position | Acacia Lynette Johnson (THERAPIST) |
| Authorized Official Contact | 5012786688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capps Wellness Clinic And Associates, Inc. 623 S Pine St Harrison AR 72601-5827 Ph: (501) 278-6688 | Capps Wellness Clinic And Associates, Inc. 623 S Pine St Harrison AR 72601-5827 Ph: (501) 278-6688 |
| NPI Number | 1124744917 |
|---|---|
| Provider Enumeration Date | 10/13/2022 |
| Last Update Date | 10/13/2022 |
| Certification Date | 10/13/2022 |
| Medicare PECOS PAC ID | 9931644994 |
|---|---|
| Medicare Enrollment ID | O20240715000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124744917 | NPI | - | NPPES |
| Provider Name | Acacia L Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912149618 PECOS PAC ID: 8022477041 Enrollment ID: I20240129002042 |
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