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CIVILPSYCH LLC NPI 1356855324


NPI Information

NPI: 1356855324
Provider Name: CIVILPSYCH, LLC

Doing Business As: CIVILPSYCH, LLC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
484 COUNTY ROAD 7593
JONESBORO, AR
ZIP 72401
Phone: (870) 932-4744
Get Directions

CIVILPSYCH, LLC is a clinic center in Jonesboro, AR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). CIVILPSYCH, LLC NPI is 1356855324. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Civilpsych, Llc.

The provider's business location address is:

484 COUNTY ROAD 7593
JONESBORO, AR
ZIP 72401-764
Phone: (870) 932-4744
Fax: (925) 955-4744

The provider's authorized official is Robert Heath Meeks .
The authorized official title is Member and has the following contact phone number (870) 932-4744.

The enumeration date for this NPI number is 11/28/2017 and was last updated on 11/28/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselor1870-CARKANSASNo
2101YA0400XCounselorAddiction (Substance Use Disorder)1870-CARKANSASNo
3101YM0800XCounselorMental Health1870-CARKANSASNo
4101YP2500XCounselorProfessional1870-CARKANSASNo
5261Q00000XClinic/Center1870-CARKANSASYes
6261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)1870-CARKANSASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11861565574MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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