Healthcare Provider Details

I. General information

NPI: 1477283323
Provider Name (Legal Business Name): JARED LOVATO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAPITOL AVE STE 1700
LITTLE ROCK AR
72201-3438
US

IV. Provider business mailing address

435 GREENE 773 RD
PARAGOULD AR
72450-9638
US

V. Phone/Fax

Practice location:
  • Phone: 501-613-0385
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90583
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: