Healthcare Provider Details

I. General information

NPI: 1639003106
Provider Name (Legal Business Name): SUSAN DIANN PASCHALL PSY.D., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 WOODY DR
ALEXANDER AR
72002-9420
US

IV. Provider business mailing address

1501 WOODY DR
ALEXANDER AR
72002-9420
US

V. Phone/Fax

Practice location:
  • Phone: 501-682-9800
  • Fax:
Mailing address:
  • Phone: 501-682-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP2605030
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: