Healthcare Provider Details

I. General information

NPI: 1649560376
Provider Name (Legal Business Name): ALLIANT BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 W SEVIER ST
BENTON AR
72019-2437
US

IV. Provider business mailing address

PO BOX 280
BENTON AR
72018-0280
US

V. Phone/Fax

Practice location:
  • Phone: 501-205-0703
  • Fax: 501-778-4889
Mailing address:
  • Phone: 501-205-0703
  • Fax: 501-778-4889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number10-25P
License Number StateAR

VIII. Authorized Official

Name: DR. SHANNON DOUGLAS PARSONS
Title or Position: OWNER
Credential: PSY.D.
Phone: 501-205-0703