Healthcare Provider Details

I. General information

NPI: 1417286691
Provider Name (Legal Business Name): TAMMY JONES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1747 N COLLEGE AVE STE 2
FAYETTEVILLE AR
72703-2606
US

IV. Provider business mailing address

PO BOX 8483
FAYETTEVILLE AR
72703-0009
US

V. Phone/Fax

Practice location:
  • Phone: 479-841-7526
  • Fax: 479-844-9755
Mailing address:
  • Phone: 479-244-2978
  • Fax: 479-844-9755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4546C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: