| Northwest Arkansas Crisis Stabilization Unit | |
|
105 N Mill Ave Fayetteville AR 72701-4273 | |
| (479) 332-0800 | |
| (479) 332-0801 |
| Full Name | Northwest Arkansas Crisis Stabilization Unit |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 105 N Mill Ave, Fayetteville, Arkansas |
| Authorized Official Name and Position | Amanda D George (VICE CHANCELLOR-CHIEF FINANCIAL OFF) |
| Authorized Official Contact | 5016865670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Arkansas Crisis Stabilization Unit 105 N Mill Ave Fayetteville AR 72701-4273 Ph: (501) 686-8000 | Northwest Arkansas Crisis Stabilization Unit 105 N Mill Ave Fayetteville AR 72701-4273 Ph: (479) 332-0800 |
| NPI Number | 1134879208 |
|---|---|
| Provider Enumeration Date | 03/24/2022 |
| Last Update Date | 08/03/2022 |
| Certification Date | 08/03/2022 |
| Medicare PECOS PAC ID | 4082528955 |
|---|---|
| Medicare Enrollment ID | O20220621002780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134879208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
| Provider Name | Jon Rubenow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013970797 PECOS PAC ID: 6507944030 Enrollment ID: I20100903000319 |
| Provider Name | Jennifer Penne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497968101 PECOS PAC ID: 9133383557 Enrollment ID: I20120615000304 |
| Provider Name | Kristen E Mcallister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346664968 PECOS PAC ID: 2264785294 Enrollment ID: I20181022001544 |
| Provider Name | Stephanie Bohannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104459114 PECOS PAC ID: 5496168031 Enrollment ID: I20201229000043 |
| Provider Name | Mary Anna Tripp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811416217 PECOS PAC ID: 2365844230 Enrollment ID: I20210714003256 |
| Provider Name | Paulette Lynn Sheagren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861684060 PECOS PAC ID: 1456741826 Enrollment ID: I20211130001053 |
| Provider Name | Heather A Humphrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366198798 PECOS PAC ID: 1557738614 Enrollment ID: I20221102000280 |
Healing Spirit Therapies, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 N East Ave, #201, Fayetteville, AR 72701 Phone: 479-200-8472 Fax: 479-442-2881 | |
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Marie W. Wood Phd Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 215 N East Ave, Fayetteville, AR 72701 Phone: 479-521-9696 | |
Spectrum Living Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3677 W Weir Rd, Fayetteville, AR 72704 Phone: 479-871-2481 | |
Rita Cruz-collins Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1747 N College Ave, Fayetteville, AR 72703 Phone: 479-305-2907 | |
Stone Path Counseling, Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 E Poplar St Ste C, Fayetteville, AR 72703 Phone: 479-435-6047 Fax: 479-755-3595 | |
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