Healthcare Provider Details

I. General information

NPI: 1336064831
Provider Name (Legal Business Name): AMBRIA LANCASTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1501 MICHAEL DR
LITTLE ROCK AR
72204-2336
US

IV. Provider business mailing address

5211 HOLLY SPRINGS BLVD
LITTLE ROCK AR
72206-4905
US

V. Phone/Fax

Practice location:
  • Phone: 501-480-5520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number29003-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: