Healthcare Provider Details

I. General information

NPI: 1699540500
Provider Name (Legal Business Name): REFLECTIONS MENTAL HEALTH SERVICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 S BRYANT ST
LITTLE ROCK AR
72204-5924
US

IV. Provider business mailing address

10128 MILL GRINDER LN
MABELVALE AR
72103-4034
US

V. Phone/Fax

Practice location:
  • Phone: 501-486-6392
  • Fax:
Mailing address:
  • Phone: 501-773-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. TEKIMA PITTS
Title or Position: OWNER/MANAGER
Credential: APRN
Phone: 501-486-6392