Healthcare Provider Details

I. General information

NPI: 1942927355
Provider Name (Legal Business Name): ALYSSA MICHELLE FLYNN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2863 N OLD MISSOURI RD STE 108D
FAYETTEVILLE AR
72703-3777
US

IV. Provider business mailing address

949 S EASTVIEW DR
FAYETTEVILLE AR
72701-7442
US

V. Phone/Fax

Practice location:
  • Phone: 479-388-0332
  • Fax: 479-239-8440
Mailing address:
  • Phone: 870-784-1378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2503014
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: