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KIDSCORP OF FAYETTEVILLE, INC
NPI 1790124659
Clinic/Center - Developmental Disabilities in Springdale, AR

Active since June 24, 2013
2210 MAIN DR, SPRINGDALE, AR 72762(479) 856-6397(479) 856-6412 Get Directions Write a Review

NPPES record last updated: October 25, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kidscorp Of Fayetteville, Inc NPPES

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

KIDSCORP OF FAYETTEVILLE, INC (NPI 1790124659) is a healthcare organization registered as a developmental disabilities in Springdale, Arkansas and active in the NPI registry since June 2013. The organization lists Shelia D. Wilkerson, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1790124659
Entity TypeOrganization
Primary Taxonomy261QD1600X
Legal Business NameKIDSCORP OF FAYETTEVILLE, INC
Location Address2210 MAIN DRSpringdale, AR 72762-6802
Mailing AddressPo Box 130Rogers, AR 72757-0130 · (479) 856-6397 · Fax (479) 856-6412
Phone(479) 856-6397
Fax(479) 856-6412
Organization SubpartNo
Authorized OfficialShelia D. WilkersonClinical Director · (479) 986-5150
Enumeration DateJune 24, 2013
Last NPPES UpdateOctober 25, 2017
✔ NPI 1790124659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Developmental DisabilitiesAmbulatory Health Care Facilities
Taxonomy Code261QD1600X
License✔ Licensed in AR · 28786
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
2210 MAIN DR, Springdale, AR 72762
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Other Identifiers 1

Medicaid198277724AR

Other Providers at the Same Location NPPES 14

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

CHRISTA GRIFFITH
Speech-Language Pathologist
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397
SERENITY HARRIS
Developmental Therapist
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397
KATHRYN TAYLOR WAREN I
Behavior Technician
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397
LEAH SCHUMACHER
Speech-Language Pathologist
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397
ASHLEY MARIE GRAY MS, CF-SLP
Speech-Language Pathologist
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397
MS. ELIZABETH JOY PUTNAM
Behavior Technician
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397
CHRISTINE HENDERSON
Behavior Technician
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397
MS. COTY DEUTSCHMAN LPN
Licensed Practical Nurse
2210 MAIN DR
SPRINGDALE, AR 72762
Washington County (479) 856-6397

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 Kidscorp Of Fayetteville, Inc's NPI number?

The NPI number for Kidscorp Of Fayetteville, Inc is 1790124659. It was assigned to this organization in the NPPES registry on June 24, 2013.

Where is Kidscorp Of Fayetteville, Inc located?

Kidscorp Of Fayetteville, Inc is located at 2210 Main Dr, Springdale, AR 72762. The listed phone number is (479) 856-6397.

What is Kidscorp Of Fayetteville, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Developmental Disabilities, with taxonomy code 261QD1600X.

When was this NPI record last updated?

The NPPES record for Kidscorp Of Fayetteville, Inc was last updated on October 25, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.