NPI 1679820278 · live from the CMS NPI Registry
Dustin Baker, Recovery Assistant
Social Worker, Clinical in Russellville, AR. National Provider Identifier 1679820278, active.
NPI record
| NPI | 1679820278 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 210 N Shamrock Blvd, Russellville, AR 72802 |
| Practice phone | 479-705-1301 |
| Mailing address | Po Box 1589, Benton, AR 72018 |
| Enumerated | August 14, 2012 |
| Last updated | September 6, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker | 104100000X | 10334-M (AR) |
| Case Manager/Care Coordinator | 171M00000X | — (AR) |
| Social Worker, Clinical primary | 1041C0700X | 10334-C (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.