Healthcare Provider Details

I. General information

NPI: 1154111227
Provider Name (Legal Business Name): CARLY ANNA LYNN PYTEL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARLY BAHNER

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 WEST MARKHAM SLOT # 568
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7101
US

V. Phone/Fax

Practice location:
  • Phone: 501-526-8200
  • Fax:
Mailing address:
  • Phone: 501-686-8000
  • Fax: 501-526-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number202387
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: