Healthcare Provider Details

I. General information

NPI: 1104150978
Provider Name (Legal Business Name): NICOLE MEGGERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 CENTRAL AVE STE 402K
HOT SPRINGS AR
71901-5349
US

IV. Provider business mailing address

701 SOUTH ST STE 100
MOUNTAIN HOME AR
72653-4452
US

V. Phone/Fax

Practice location:
  • Phone: 501-383-3500
  • Fax:
Mailing address:
  • Phone: 501-383-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4943-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: