Provider Demographics
NPI:1356406276
Name:BEHAVIORAL MEDICINE ASSOCIATES, LLC
Entity type:Organization
Organization Name:BEHAVIORAL MEDICINE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-305-4068
Mailing Address - Street 1:916 E RACE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4617
Mailing Address - Country:US
Mailing Address - Phone:501-305-4068
Mailing Address - Fax:501-279-3760
Practice Address - Street 1:916 E RACE AVE STE A
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4617
Practice Address - Country:US
Practice Address - Phone:501-305-4068
Practice Address - Fax:501-279-3760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMC-22112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR152166002Medicaid
AR5C960Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER