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NPI Code Detail

MEDICARE: MRS. ANDREA STILES LCSW

MEDICARE: MRS. ANDREA STILES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
21041C0700XClinical Social Worker1931-CAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15A348OTHERARBCBS
25Y348OTHERARBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
45Y348OTHERARBLUECROSS PROVIDER NUMBER

General Provider Information

NPI Number : 1073529491
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANDREA STILES LCSW
Provider Business Mailing Address
First Line : 1815 PLEASANT GROVE RD
Second Line :
City : JONESBORO
State : AR
Zip : 72401-7870
Country : US
Telephone Number : 870-933-6886
Fax Number : 870-933-9395
Provider Business Practice Location Address
First Line : 2126 N 1ST ST STE F
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-2868
Country : US
Telephone Number : 501-982-5000
Fax Number : 501-982-5007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 05/09/2018

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Directions to “ MRS. ANDREA STILES LCSW” Practice Location

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