Organization
WHITE RIVER HEALTH SYSTEM, INC.
Active
Other names
White River Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA BAXTER (PROVIDER ENROLLMENT)
(870) 262-5545
Entity
Organization
Contact information
Practice address
2230 HARRISON ST, BATESVILLE, AR 72501-7417
(870) 698-2100
(870) 698-0109
Mailing address
1710 HARRISON ST, BATESVILLE, AR 72501-7303
(870) 698-2100
(870) 698-0109
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141670002
—
AR
01
—
5C532
MEDICARE NUMBER
AR
Enumeration date
02/22/2006
Last updated
05/02/2024
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