MEDICARE: THE LOGAN CENTERS, INC.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor
3	1041C0700X	Clinical Social Worker
4	2084P0800X	Psychiatry Physician
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

#	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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1932119187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LOGAN CENTERS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 11064
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-1001
Country	:	US
Telephone Number	:	870-520-5014
Fax Number	:	870-520-5015

Provider Business Practice Location Address
First Line	:	3305 E HIGHLAND DR STE B
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72401-6491
Country	:	US
Telephone Number	:	870-520-5014
Fax Number	:	870-520-5015

Authorized Official
Title or Position	:	CEO
Name	:	SHANNON SHERMAN
Credential	:
Telephone Number	:	870-520-5014

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/20/2025

3305 E HIGHLAND DR STE A
JONESBORO, AR
72401-6491

Practice Phone: 870-934-9900
Practice Fax: 870-934-9920