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NPI Code Detail

MEDICARE: HANNAH JAMISON LAC

MEDICARE: HANNAH JAMISON LAC
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
1101YM0800XMental Health CounselorA2AR

General Provider Information

NPI Number : 1639038425
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH JAMISON LAC
Provider Business Mailing Address
First Line : 910 N EAST ST
Second Line :
City : BENTON
State : AR
Zip : 72015-3327
Country : US
Telephone Number : 501-381-2001
Fax Number : 501-381-2005
Provider Business Practice Location Address
First Line : 910 N EAST ST
Second Line :
City : BENTON
State : AR
Zip : 72015-3327
Country : US
Telephone Number : 501-381-2001
Fax Number : 501-381-2005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ HANNAH JAMISON LAC” Practice Location

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