Healthcare Provider Details

I. General information

NPI: 1730249715
Provider Name (Legal Business Name): JAN GREEN HARRISON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S UNIVERSITY AVE STE 200
LITTLE ROCK AR
72205-5215
US

IV. Provider business mailing address

1501 N UNIVERSITY AVE STE 915
LITTLE ROCK AR
72207-5238
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-9050
  • Fax: 501-296-9323
Mailing address:
  • Phone: 501-492-6860
  • Fax: 501-406-3671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1810-C
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1810-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: