Healthcare Provider Details

I. General information

NPI: 1225972128
Provider Name (Legal Business Name): MINDSHIFT INTEGRATED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10515 W MARKHAM ST STE G1
LITTLE ROCK AR
72205-2296
US

IV. Provider business mailing address

4 BJORN BORG CT
LITTLE ROCK AR
72210-5721
US

V. Phone/Fax

Practice location:
  • Phone: 501-944-2047
  • Fax:
Mailing address:
  • Phone: 501-944-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TARKEISHER LAMBERT-JONES
Title or Position: OWNER
Credential: LPC
Phone: 501-944-2047