| Chosen One Professional Services, Llc. | |
|
320 N Rosser St Forrest City AR 72335-3247 | |
| (870) 510-4981 | |
| Not Available |
| Full Name | Chosen One Professional Services, Llc. |
|---|---|
| Speciality | Social Worker |
| Location | 320 N Rosser St, Forrest City, Arkansas |
| Authorized Official Name and Position | Melrita Maechel Johnson (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 8705199482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chosen One Professional Services, Llc. Po Box 13810 Maumelle AR 72113-0810 Ph: (870) 519-9482 | Chosen One Professional Services, Llc. 320 N Rosser St Forrest City AR 72335-3247 Ph: (870) 510-4981 |
| NPI Number | 1578129201 |
|---|---|
| Provider Enumeration Date | 05/17/2019 |
| Last Update Date | 05/15/2023 |
| Certification Date | 05/15/2023 |
| Medicare PECOS PAC ID | 3577891050 |
|---|---|
| Medicare Enrollment ID | O20190821003547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578129201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Melrita M Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013032754 PECOS PAC ID: 4486982964 Enrollment ID: I20190822000868 |
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