Provider Demographics
NPI:1285606293
Name:SHEARER, RISSA D (LPC)
Entity type:Individual
Prefix:MS
First Name:RISSA
Middle Name:D
Last Name:SHEARER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6399
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71902-6399
Mailing Address - Country:US
Mailing Address - Phone:501-624-7111
Mailing Address - Fax:501-620-5109
Practice Address - Street 1:700 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-3423
Practice Address - Country:US
Practice Address - Phone:501-624-7111
Practice Address - Fax:501-620-5109
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0104018101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR60054OtherAETNA
AR2204691OtherCIGNA BEHAVIORAL HEALTH
AR5S961OtherBLUE CROSS & BLUE SHIELD
AR962419OtherUSA MANAGED CARE
AR22783OtherMHN NETWORK
AR4100021400OtherQUAL-CHOICE
AR531999OtherVALUE OPTIONS