ANDREW DONOVAN LAC
NPI 1972043792
Counselor - Professional in Benton, AR

Active since February 27, 2017PECOS EnrolledAccepts Medicare Assignment
1502 MARY KAY BLVD, BENTON, AR 72015(501) 315-3344 Get Directions Write a Review

NPPES record last updated: January 12, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 12, 2022, Nov 12, 2018, Sep 25, 2018 and 1 more (4 updates tracked since 2017).

About Andrew Donovan Lac NPPES

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

ANDREW DONOVAN LAC (NPI 1972043792) is an individual professional provider in Benton, Arkansas, licensed in Arkansas (P2110003) and active in the NPI registry since February 2017. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fayetteville, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1972043792
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameANDREW DONOVANCredential: LAC
Location Address1502 MARY KAY BLVDBenton, AR 72015
Mailing AddressPo Box 1589Benton, AR 72018-1589 · (501) 315-3344
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateFebruary 27, 2017
Last NPPES UpdateJanuary 12, 20224 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2022
NPI 1972043792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in AR · P2110003
Also ListedCounselorTaxonomy 101Y00000X · License A1810152 (AR)
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
1502 MARY KAY BLVD, Benton, AR 72015

Secondary Practice Location 1

Location 13715 N Business Dr Ste 104Fayetteville, AR 72703-5287 · Phone (479) 575-9471 ext. 35012

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Andrew Donovan Lac 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 ID1658722343
PECOS Enrollment IDI20240106000649
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.

Other Providers at the Same Location NPPES 20

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

Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015
Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015
Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015
Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015
Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015
Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015
Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015
Case Manager/Care Coordinator
1502 MARY KAY BLVD
BENTON, AR 72015

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 Andrew Donovan's NPI number?

The NPI number for Andrew Donovan is 1972043792. It was assigned to this individual provider in the NPPES registry on February 27, 2017.

Where is Andrew Donovan located?

Andrew Donovan practices at 1502 Mary Kay Blvd, Benton, AR 72015. The listed phone number is (501) 315-3344.

What is Andrew Donovan's specialty?

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

Is Andrew Donovan enrolled in Medicare?

Yes. Andrew Donovan 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.

What insurance does Andrew Donovan accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Andrew Donovan 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 Andrew Donovan was last updated on January 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.