Provider Demographics
NPI:1598730566
Name:MCGREW, KRISTEN TENNILLE (EDD, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:TENNILLE
Last Name:MCGREW
Suffix:
Gender:F
Credentials:EDD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-945-8838
Mailing Address - Fax:501-945-8835
Practice Address - Street 1:3201 SPRINGHILL DR STE 400
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2910
Practice Address - Country:US
Practice Address - Phone:501-945-8838
Practice Address - Fax:501-945-8835
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0508056101YM0800X
ARP0802014101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR710401764OtherARCADIAN HEALH PLAN FOR ARK COMMUNIT CARE
AR15987305566OtherBCBS
AR1598730566OtherMAGELLAN
AR2553395OtherCIGNA
AR710401764OtherCORP HEALTH
AR1098797OtherUSA MGD CARE
AR710401764OtherUNITY MGD CARE
AR08040013300OtherQUAL CHOICE
AR418023OtherMHN
AR116399726Medicaid
AR710401764OtherNOVA SYSTEMS