Healthcare Provider Details

I. General information

NPI: 1700671864
Provider Name (Legal Business Name): ANNA CONE, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 E CENTER ST STE 200G
FAYETTEVILLE AR
72701-5365
US

IV. Provider business mailing address

PO BOX 63
TONTITOWN AR
72770-0063
US

V. Phone/Fax

Practice location:
  • Phone: 479-348-5308
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNA CONE
Title or Position: OWNER
Credential: LCSW
Phone: 501-470-8744