Healthcare Provider Details
I. General information
NPI: 1427333624
Provider Name (Legal Business Name): MELANIE MJ SUTTON L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/19/2011
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6834 CANTRELL RD STE 1004
LITTLE ROCK AR
72207-4135
US
IV. Provider business mailing address
1005 S GERMAN LN APT 30
CONWAY AR
72034-6078
US
V. Phone/Fax
- Phone: 501-313-0939
- Fax:
- Phone: 918-630-6018
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: