Basic Information
| Provider Information | |||||||||
| NPI: | 1588709646 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PERSPECTIVES BEHAVIORAL HEALTH MANAGEMENT, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 23070 | ||||||||
| Address2: | |||||||||
| City: | BARLING | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729230070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4794525040 | ||||||||
| FaxNumber: | 4794525047 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 FORT ST | ||||||||
| Address2: | |||||||||
| City: | BARLING | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729232646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4794345002 | ||||||||
| FaxNumber: | 4794345009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2007 | ||||||||
| LastUpdateDate: | 09/03/2019 | ||||||||
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| AuthorizedOfficialLastName: | TUCKER | ||||||||
| AuthorizedOfficialFirstName: | KERRI | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO-INTERIM | ||||||||
| AuthorizedOfficialTelephone: | 4794525040 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 164W00000X | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Licensed Practical Nurse | 171M00000X | N | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Case Manager/Care Coordinator | 101Y00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | 103T00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | 104100000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | 106H00000X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 2084P0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 171893526 | 05 | AR | MEDICAID | 171894526 | 05 | AR | MEDICAID | 171896526 | 05 | AR | MEDICAID | 174972526 | 05 | AR | MEDICAID | 5GA77 | 01 | AR | MEDICARE ID | OTHER | 171892526 | 05 | AR | MEDICAID | 171895526 | 05 | AR | MEDICAID | 171897526 | 05 | AR | MEDICAID | 171898526 | 05 | AR | MEDICAID | 171899526 | 05 | AR | MEDICAID | 156877526 | 05 | AR | MEDICAID | 171901526 | 05 | AR | MEDICAID |