| Point Momentum, P.l.l.c. | |
|
4257 Gabel Drive Fayetteville AR 72703 | |
| (479) 856-2602 | |
| Not Available |
| Full Name | Point Momentum, P.l.l.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4257 Gabel Drive, Fayetteville, Arkansas |
| Authorized Official Name and Position | Zach A Newcomb (DIRECTOR) |
| Authorized Official Contact | 4798562602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Point Momentum, P.l.l.c. 4052 North Abington Court Fayetteville AR 72703 Ph: (479) 856-2602 | Point Momentum, P.l.l.c. 4257 Gabel Drive Fayetteville AR 72703 Ph: (479) 856-2602 |
| NPI Number | 1386920049 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 10/26/2011 |
| Medicare PECOS PAC ID | 3577822089 |
|---|---|
| Medicare Enrollment ID | O20180109000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386920049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2556-C (Arkansas) | Primary |
| Provider Name | Zachary Newcomb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184914152 PECOS PAC ID: 4486913993 Enrollment ID: I20180109000228 |
| Provider Name | Vaughn A Decoster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689634255 PECOS PAC ID: 8628450780 Enrollment ID: I20220805001262 |
| Provider Name | Hannah Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285247072 PECOS PAC ID: 4385016575 Enrollment ID: I20230216002201 |
| Provider Name | Denise Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720641756 PECOS PAC ID: 0244689487 Enrollment ID: I20231213000390 |
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