MANDY COLBURN OBAOYE (LCSW) – Clinical Social Worker, NPI 1104032127

MANDY COLBURN OBAOYE (LCSW) is a healthcare provider. based in Jonesboro, Arkansas. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 2568-C (AR). The NPI Number for MANDY COLBURN OBAOYE (LCSW) is 1104032127

Main info

Female
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
MANDY COLBURN OBAOYE (LCSW)
NPI
1104032127
Phone
(870) 972-4939
Address
2707 BROWNS LN
Enumeration Date
15 May 2007
Last Update Date
19 January 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8709724100
Graduation Year
2008 (18 years ago)
PAC ID
7911189311
Group Practice PAC ID
0941105480
Professional Enrollment ID
I20110307000354
Address ID
AR724051874JO2712XAVEX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

681 CLINICAL SOCIAL WORKER in AR

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Provider Addresses for MANDY COLBURN OBAOYE (LCSW)

  • 2707, Browns Lane, Jonesboro, Craighead County, Arkansas, 72401, United States

    JONESBORO, AR 724017213

    Phone: (870) 972-4939

    Fax: (870) 972-4911

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-03-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110307000354IClinical Social WorkerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941105480View full group profile
NameSpecialtyState
Internal MedicineAR
Clinical Social WorkerAR
-AR
P S Y C H I A T R YTX
-CA
Nurse PractitionerAR
Nurse PractitionerAR
Hospitalist, Internal Medicine, HospitalistKY
Pulmonary DiseaseAR
Nurse PractitionerAR

Reviews

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Frequently asked questions

How is MANDY COLBURN OBAOYE (LCSW) identified in CMS data?
CMS-hosted NPPES data lists MANDY COLBURN OBAOYE (LCSW) with NPI 1104032127.
Is MANDY COLBURN OBAOYE (LCSW) listed as active for patients and plans?
The listing shows MANDY COLBURN OBAOYE (LCSW) as active in the NPI system.
What taxonomy line describes MANDY COLBURN OBAOYE (LCSW)?
For research purposes, treat MANDY COLBURN OBAOYE (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for MANDY COLBURN OBAOYE (LCSW)?
MANDY COLBURN OBAOYE (LCSW)'s geographic hint is Jonesboro, Arkansas in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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