| Conway Counseling & Psychological Services, Pllc | |
|
1312 Donaghey Ave Conway AR 72034-3807 | |
| (501) 366-3600 | |
| Not Available |
| Full Name | Conway Counseling & Psychological Services, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 1312 Donaghey Ave, Conway, Arkansas |
| Authorized Official Name and Position | Ayisha R Kellybrew-miller (OWNER) |
| Authorized Official Contact | 5013363600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway Counseling & Psychological Services, Pllc 1312 Donaghey Ave Conway AR 72034-3807 Ph: (501) 366-3600 | Conway Counseling & Psychological Services, Pllc 1312 Donaghey Ave Conway AR 72034-3807 Ph: (501) 366-3600 |
| NPI Number | 1528454139 |
|---|---|
| Provider Enumeration Date | 04/09/2015 |
| Last Update Date | 04/09/2015 |
| Medicare PECOS PAC ID | 4183933781 |
|---|---|
| Medicare Enrollment ID | O20151022000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528454139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | P0409039 (Arkansas) | Primary |
| Provider Name | John C Knott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033123294 PECOS PAC ID: 0345241766 Enrollment ID: I20070126000318 |
| Provider Name | Paula L Mercer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811079429 PECOS PAC ID: 9032110440 Enrollment ID: I20070129000275 |
| Provider Name | Kelly J Pizzitola |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043410608 PECOS PAC ID: 4789777699 Enrollment ID: I20070910000237 |
| Provider Name | Samnieng Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821189879 PECOS PAC ID: 2769552082 Enrollment ID: I20080529000464 |
| Provider Name | Jennifer L Embry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396998910 PECOS PAC ID: 4082765011 Enrollment ID: I20090701000627 |
| Provider Name | Kay C Hook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043297302 PECOS PAC ID: 3971759952 Enrollment ID: I20120807000398 |
| Provider Name | Melanie L Cook Dobbins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710016662 PECOS PAC ID: 1850602673 Enrollment ID: I20150622000383 |
| Provider Name | Danielle Bell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174813067 PECOS PAC ID: 2062658057 Enrollment ID: I20150808015742 |
| Provider Name | Cariann M Bergner-moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003369950 PECOS PAC ID: 4385930866 Enrollment ID: I20160909000137 |
| Provider Name | Marian L Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548497100 PECOS PAC ID: 8820141187 Enrollment ID: I20180214002074 |
| Provider Name | Beth L Craft |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962630947 PECOS PAC ID: 3375550635 Enrollment ID: I20180302000960 |
| Provider Name | Kelly N Malcom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043705726 PECOS PAC ID: 6709134026 Enrollment ID: I20180802002873 |
| Provider Name | Devin Annette Chatman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396224002 PECOS PAC ID: 7214287077 Enrollment ID: I20180829002030 |
| Provider Name | David A Steinfeld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043790611 PECOS PAC ID: 3476804568 Enrollment ID: I20181001000075 |
| Provider Name | Bambi M Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114233889 PECOS PAC ID: 1759635154 Enrollment ID: I20181126000124 |
| Provider Name | Schantz A Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164054649 PECOS PAC ID: 2466881909 Enrollment ID: I20200403000479 |
| Provider Name | Mander Heath Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437462348 PECOS PAC ID: 7113342692 Enrollment ID: I20200730002506 |
| Provider Name | Summer Westerberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194851766 PECOS PAC ID: 3274952148 Enrollment ID: I20200925000905 |
| Provider Name | Channing Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104464445 PECOS PAC ID: 4880013713 Enrollment ID: I20200928000275 |
| Provider Name | Sara Deboer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740773985 PECOS PAC ID: 0143633735 Enrollment ID: I20201228000686 |
| Provider Name | Matthew Reel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568718930 PECOS PAC ID: 1153723358 Enrollment ID: I20210712000182 |
| Provider Name | Katherine Henkel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093280067 PECOS PAC ID: 0446655161 Enrollment ID: I20210818003201 |
| Provider Name | Todd Deneen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780053231 PECOS PAC ID: 0547577520 Enrollment ID: I20220316000278 |
| Provider Name | Anna Knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568743086 PECOS PAC ID: 3173900149 Enrollment ID: I20220512000589 |
| Provider Name | Diana J Schmitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275078149 PECOS PAC ID: 8426472978 Enrollment ID: I20220726001831 |
| Provider Name | Elizabeth Hale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669083176 PECOS PAC ID: 8729457171 Enrollment ID: I20221207002250 |
| Provider Name | James D Mccormack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487102596 PECOS PAC ID: 6507231545 Enrollment ID: I20230405001485 |
| Provider Name | Angela M Holyfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790311314 PECOS PAC ID: 5092175612 Enrollment ID: I20230714000614 |
| Provider Name | David M Reynolds |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356580666 PECOS PAC ID: 1052754066 Enrollment ID: I20240207000553 |
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