MEDICARE: MACI NICOLE SCUDDER 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
1	1041C0700X	Clinical Social Worker	8905-C	AR
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1326524927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACI NICOLE SCUDDER LCSW

Provider Business Mailing Address
First Line	:	1501 N UNIVERSITY AVE STE 915
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72207-5238
Country	:	US
Telephone Number	:	501-492-6860
Fax Number	:	501-406-3671

Provider Business Practice Location Address
First Line	:	1501 N UNIVERSITY AVE STE 915
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72207-5238
Country	:	US
Telephone Number	:	501-492-6860
Fax Number	:	501-406-3671

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2018
Last Update Date	:	02/13/2026

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Directions to “ MACI NICOLE SCUDDER LCSW” Practice Location

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