Healthcare Provider Details

I. General information

NPI: 1780010223
Provider Name (Legal Business Name): ALEXA DONLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 N PECAN ST
BEEBE AR
72012-2524
US

IV. Provider business mailing address

172 RICHARD LAUEN RD
SEARCY AR
72143-9654
US

V. Phone/Fax

Practice location:
  • Phone: 501-232-2600
  • Fax: 501-242-0820
Mailing address:
  • Phone: 314-677-4701
  • Fax: 501-242-0820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA2406018
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: