Healthcare Provider Details

I. General information

NPI: 1023771979
Provider Name (Legal Business Name): AMY MCNABB LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 MEDICAL CENTER PKWY
CLINTON AR
72031-7946
US

IV. Provider business mailing address

PO BOX 1060
MARSHALL AR
72650-1060
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-7888
  • Fax:
Mailing address:
  • Phone: 870-448-5733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number27262-M
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number27262-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: