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MOONBROOK MIND & BODY INTEGRATIVE SERVICES INCORPORATED
NPI 1376173401
Social Worker - Clinical in Texarkana, AR

Active since January 16, 2020
421 PECAN ST, TEXARKANA, AR 71854(870) 330-4095(844) 706-5741 Get Directions Write a Review

NPPES record last updated: January 20, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 20, 2026, Sep 17, 2025, Jan 11, 2023 and 2 more (5 updates tracked since 2020).

About Moonbrook Mind & Body Integrative Services Incorporated NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOONBROOK MIND & BODY INTEGRATIVE SERVICES INCORPORATED (NPI 1376173401) is a healthcare organization registered as a clinical in Texarkana, Arkansas and active in the NPI registry since January 2020. The organization lists Jessica Kennington, Owner, as its authorized official.

NPPES Registry Identity

NPI1376173401
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameMOONBROOK MIND & BODY INTEGRATIVE SERVICES INCORPORATED
Location Address421 PECAN STTexarkana, AR 71854-5333
Mailing Address421 Pecan StTexarkana, AR 71854-5333 · (870) 330-4095 · Fax (844) 706-5461
Phone(870) 330-4095
Fax(844) 706-5741
Organization SubpartNo
Authorized OfficialJessica KenningtonOwner · (870) 330-4095
Enumeration DateJanuary 16, 2020
Last NPPES UpdateJanuary 20, 20265 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2026
✔ NPI 1376173401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
421 PECAN ST, Texarkana, AR 71854
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Moonbrook Mind & Body Integrative Services Incorporated is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Moonbrook Mind & Body Integrative Services Incorporated, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Kelli Mayall, LPC
Mental Health Counselor
NPI 1952894545
4613 PARKWAY DR STE 7
Texarkana, AR 71854
(870) 330-4095
✔ PECOS✔ Accepts Medicare3.2 mi
Jessica Kennington, LCSW
Clinical Social Worker
NPI 1902219587
4613 PARKWAY DR STE 7
Texarkana, AR 71854
(870) 330-4095
✔ PECOS✔ Accepts Medicare3.2 mi
Alana Mrugala, LPC
Mental Health Counselor
NPI 1093399198
203 HARNETT CT
Clarksville, TN 37043
(931) 614-7397
✔ PECOS439 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moonbrook Mind & Body Integrative Services Incorporated's NPI number?

The NPI number for Moonbrook Mind & Body Integrative Services Incorporated is 1376173401. It was assigned to this organization in the NPPES registry on January 16, 2020.

Where is Moonbrook Mind & Body Integrative Services Incorporated located?

Moonbrook Mind & Body Integrative Services Incorporated is located at 421 Pecan St, Texarkana, AR 71854. The listed phone number is (870) 330-4095.

What is Moonbrook Mind & Body Integrative Services Incorporated's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Moonbrook Mind & Body Integrative Services Incorporated enrolled in Medicare?

Yes. Moonbrook Mind & Body Integrative Services Incorporated is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Moonbrook Mind & Body Integrative Services Incorporated?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Moonbrook Mind & Body Integrative Services Incorporated, in Clinical Social Worker and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Moonbrook Mind & Body Integrative Services Incorporated was last updated on January 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.