MEDICARE: MRS. CHARLOTTE ANN FEATHERSTON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2023040471	MO
2	101Y00000X	Counselor	P1206072	AR
3	251B00000X	Case Management Agency		MO
4	101Y00000X	Counselor	A0612081	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679723225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHARLOTTE ANN FEATHERSTON LPC

Provider Business Mailing Address
First Line	:	PO BOX 1142
Second Line	:
City	:	MAMMOTH SPRING
State	:	AR
Zip	:	72554-1142
Country	:	US
Telephone Number	:	870-907-0848
Fax Number	:	417-322-6099

Provider Business Practice Location Address
First Line	:	250 ARCHER AVE
Second Line	:
City	:	MAMMOTH SPRING
State	:	AR
Zip	:	72554-8020
Country	:	US
Telephone Number	:	870-907-0848
Fax Number	:	417-322-6099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2008
Last Update Date	:	10/07/2025

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Directions to “ MRS. CHARLOTTE ANN FEATHERSTON LPC” Practice Location

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