Healthcare Provider Details

I. General information

NPI: 1003110420
Provider Name (Legal Business Name): JOSHUA PURSIFULL M.S. L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 MERRILL DR STE D220
LITTLE ROCK AR
72211-1654
US

IV. Provider business mailing address

PO BOX 251970
LITTLE ROCK AR
72225-1970
US

V. Phone/Fax

Practice location:
  • Phone: 501-666-8686
  • Fax: 501-660-6830
Mailing address:
  • Phone: 501-666-8686
  • Fax: 501-660-6830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA1103025
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: