| Thriveworks Conway | |
|
575 Club Ln Suite 103 Conway AR 72034-3681 | |
| (501) 745-6644 | |
| Not Available |
| Full Name | Thriveworks Conway |
|---|---|
| Speciality | Counselor |
| Location | 575 Club Ln, Conway, Arkansas |
| Authorized Official Name and Position | Curtis Robinson (OFFICE MANAGER) |
| Authorized Official Contact | 5017456644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriveworks Conway 1059 Vista Park Dr Suite B Forest VA 24551-4253 Ph: () - | Thriveworks Conway 575 Club Ln Suite 103 Conway AR 72034-3681 Ph: (501) 745-6644 |
| NPI Number | 1851702724 |
|---|---|
| Provider Enumeration Date | 05/14/2014 |
| Last Update Date | 05/14/2014 |
| Medicare PECOS PAC ID | 5597024612 |
|---|---|
| Medicare Enrollment ID | O20180118001536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851702724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jo Ann Clay |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1003843277 PECOS PAC ID: 0143245738 Enrollment ID: I20051012001003 |
| Provider Name | Sharon A Odom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033196324 PECOS PAC ID: 0345313425 Enrollment ID: I20130225000188 |
| Provider Name | Andrew Jay Keough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851628481 PECOS PAC ID: 1355662487 Enrollment ID: I20150602000596 |
| 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 | Brian Christopher Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134468895 PECOS PAC ID: 0547542599 Enrollment ID: I20180112000030 |
| Provider Name | Stephanie L Galloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962855676 PECOS PAC ID: 7618214404 Enrollment ID: I20190201001335 |
| Provider Name | Zackary D Coco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194236935 PECOS PAC ID: 6709117526 Enrollment ID: I20191009002102 |
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