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MR. JUSTIN QUALLS LPC
NPI 1780299859
Counselor - Professional in Russellville, AR

Active since September 15, 2020PECOS EnrolledAccepts Medicare Assignment
104 LOCK AND DAM RD, RUSSELLVILLE, AR 72802(479) 567-1864(636) 324-8551 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 20, 2025, Mar 8, 2023, Jan 4, 2023 and 1 more (4 updates tracked since 2020).

About Mr. Justin Qualls Lpc NPPES

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

MR. JUSTIN QUALLS LPC (NPI 1780299859) is an individual professional provider in Russellville, Arkansas, licensed in Arkansas (P2303003) and active in the NPI registry since September 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1780299859
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. JUSTIN QUALLSCredential: LPC
Location Address104 LOCK AND DAM RDRussellville, AR 72802-9725
Mailing Address104 Lock And Dam RdRussellville, AR 72802-9725 · (479) 747-5222 · Fax (636) 324-8551
Phone(479) 567-1864
Fax(636) 324-8551
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateSeptember 15, 2020
Last NPPES UpdateOctober 15, 20254 updates tracked since enumeration
NPPES CertifiedOctober 15, 2025
✔ NPI 1780299859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in AR · P2303003
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License A2009111 (AR)
104 LOCK AND DAM RD, Russellville, AR 72802
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Justin Qualls Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476990383
PECOS Enrollment IDI20250819001422
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Justin Qualls reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

River Valley Youth Foundation
Same address
Community/Behavioral Health
104 LOCK AND DAM RD
Russellville, AR 72802
  • Reassigned Medicare billing, Arkansas enrollment
  • 10 clinicians in this Medicare group
NPI 1770261869 (479) 567-5280

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

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAVEN CRUZ-HUMBERTO
Counselor
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (479) 747-5222
SEUMR LONG
Community/Behavioral Health
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (479) 222-0268
KENDRA HILL
Case Manager/Care Coordinator
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (870) 266-6220
TOBY AARON RICHARD
Case Manager/Care Coordinator
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (479) 567-5530
SHANA ADAMS
Social Worker
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (479) 747-5222
KRISTY PETERS PLMSW
Social Worker
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (479) 747-5222
JONNA M TAYLOR MSW
Social Worker
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (479) 222-0268
SHELBI LYNN CAIN
Counselor (Mental Health)
104 LOCK AND DAM RD
RUSSELLVILLE, AR 72802
Pope County (479) 747-5222

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 Justin Qualls's NPI number?

The NPI number for Justin Qualls is 1780299859. It was assigned to this individual provider in the NPPES registry on September 15, 2020.

Where is Justin Qualls located?

Justin Qualls practices at 104 Lock And Dam Rd, Russellville, AR 72802. The listed phone number is (479) 567-1864.

What is Justin Qualls's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Justin Qualls enrolled in Medicare?

Yes. Justin Qualls is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Justin Qualls's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Qualls reassigns Medicare benefits to River Valley Youth Foundation (Russellville, AR). The 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 Justin Qualls's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Justin Qualls accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Justin Qualls as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Justin Qualls was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.