Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Justin Qualls, LPC

Individual provider Professional Counselor · NPI 1780299859

Mr. Justin Qualls, LPC is a Mental Health Counselor in Russellville, Arkansas. Qualified in 2020, 6 years ago. Practices with River Valley Youth Foundation, a 2-clinician group and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
6
Licensed in
AR
In the registry since
2020
Specialties on file
3
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

104 Lock And Dam Rd
Russellville, AR 72802-9725
Phone: (479) 567-1864
Fax: (636) 324-8551
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence P2303003 (AR)
Mental Health Counselor Taxonomy 101YM0800X · Licence A2009111 (AR)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1780299859
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorNo
NPI enumeratedSeptember 15, 2020
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice River Valley Youth Foundation — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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