Healthcare Provider Details

I. General information

NPI: 1649194242
Provider Name (Legal Business Name): LEAH MIRIAM GOLDSHOLL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST # 629
LITTLE ROCK AR
72205-7199
US

IV. Provider business mailing address

37 IVIERS DR
LITTLE ROCK AR
72223-9143
US

V. Phone/Fax

Practice location:
  • Phone: 501-503-8296
  • Fax: 501-526-6854
Mailing address:
  • Phone: 501-603-1612
  • Fax: 501-526-6854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number28707-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: