NPI Code Detail JSON Logo

1619774411 NPI number — MATRIX BEHAVIORAL COUNSELING PLC

NPI Number: 1619774411
Health Care Provider/Practitioner: MATRIX BEHAVIORAL COUNSELING PLC

Information about “1619774411” NPI (MATRIX BEHAVIORAL COUNSELING PLC) exists in 1619774411 in HTML format HTML  |  1619774411 in plain Text format TXT  |  1619774411 in PDF (Portable Document Format) PDF  |  1619774411 in an XML format XML  formats.

NPI Number : 1619774411 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619774411",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MATRIX BEHAVIORAL COUNSELING PLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 390",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MOUNTAIN VIEW",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "72560-0390",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "870-269-1337",
    "MailingAddressFaxNumber": "870-269-1338",
    "FirstLinePracticeLocationAddress": "503 W MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOUNTAIN VIEW",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "72560-9167",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "870-269-1337",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/27/2025",
    "LastUpdateDate": "10/27/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "NESBITT",
    "AuthorizedOfficialFirstName": "WILLIAM",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CREDENTIALING SPECIALIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMSW",
    "AuthorizedOfficialTelephoneNumber": "870-269-1337",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.