| Changes Behavioral Health, Llc | |
|
204 Mississippi St S Wynne AR 72396-3025 | |
| (870) 208-8499 | |
| Not Available |
| Full Name | Changes Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 204 Mississippi St S, Wynne, Arkansas |
| Authorized Official Name and Position | Brian Dickson Shaw (THERAPIST) |
| Authorized Official Contact | 9015700556 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Changes Behavioral Health, Llc 204 Mississippi St S Wynne AR 72396-3025 Ph: (870) 208-8499 | Changes Behavioral Health, Llc 204 Mississippi St S Wynne AR 72396-3025 Ph: (870) 208-8499 |
| NPI Number | 1114260486 |
|---|---|
| Provider Enumeration Date | 04/04/2013 |
| Last Update Date | 01/06/2015 |
| Medicare PECOS PAC ID | 6103149653 |
|---|---|
| Medicare Enrollment ID | O20150108001118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114260486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5606C (Arkansas) | Primary |
| Provider Name | Olimpia Rosario |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1225242043 PECOS PAC ID: 7012183692 Enrollment ID: I20120103000389 |
| Provider Name | Brian Dickson Shaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396949517 PECOS PAC ID: 7911220462 Enrollment ID: I20150108001434 |
| Provider Name | Nga T Huynh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679716013 PECOS PAC ID: 7911127014 Enrollment ID: I20151103000871 |
| Provider Name | Alison Hobson Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619460813 PECOS PAC ID: 6103176516 Enrollment ID: I20180906000072 |
| Provider Name | Priscilla Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821518242 PECOS PAC ID: 8123456928 Enrollment ID: I20200310000117 |
| Provider Name | Amber Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083822605 PECOS PAC ID: 7416344940 Enrollment ID: I20220430000032 |
| Provider Name | Edith Renee Sherman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629249131 PECOS PAC ID: 7810350840 Enrollment ID: I20230824000161 |
| Provider Name | Samantha Sharp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477763126 PECOS PAC ID: 3779935440 Enrollment ID: I20240118000565 |
| Provider Name | Michael S. Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396998605 PECOS PAC ID: 2163874371 Enrollment ID: I20240123002771 |
| Provider Name | Deena Ann Shaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497095954 PECOS PAC ID: 2961855945 Enrollment ID: I20240125002966 |
| Provider Name | Laura Felton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922601178 PECOS PAC ID: 5193168979 Enrollment ID: I20240208002189 |
| Provider Name | Katelyn Kyle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265980593 PECOS PAC ID: 9537503867 Enrollment ID: I20240215001257 |
| Provider Name | Alicia D Peeler-turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780822973 PECOS PAC ID: 0547604043 Enrollment ID: I20240222002795 |
| Provider Name | Stephanie Kay Collier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841503299 PECOS PAC ID: 1355786161 Enrollment ID: I20240304001025 |
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