Healthcare Provider Details

I. General information

NPI: 1700858362
Provider Name (Legal Business Name): CHRISTINA L ADAMS LPE-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 ALTUS ST STE 110
CONWAY AR
72032-4299
US

IV. Provider business mailing address

PO BOX 9662
CONWAY AR
72033-9662
US

V. Phone/Fax

Practice location:
  • Phone: 501-852-1366
  • Fax: 501-852-1367
Mailing address:
  • Phone: 501-852-1363
  • Fax: 501-852-1364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number02-06EI
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: