Healthcare Provider Details

I. General information

NPI: 1831013861
Provider Name (Legal Business Name): EMILEE MARTIN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 PLEASANT GROVE RD
JONESBORO AR
72405-7870
US

IV. Provider business mailing address

1101 W MORGAN ST STE 8
PARAGOULD AR
72450-2848
US

V. Phone/Fax

Practice location:
  • Phone: 870-933-6886
  • Fax: 870-933-9395
Mailing address:
  • Phone: 870-933-6886
  • Fax: 870-933-9395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11632-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: