Healthcare Provider Details
I. General information
NPI: 1487205357
Provider Name (Legal Business Name): CENTRAL ARKANSAS PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2019
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
523 N UNIVERSITY AVE
LITTLE ROCK AR
72205-2916
US
IV. Provider business mailing address
523 N UNIVERSITY AVE
LITTLE ROCK AR
72205-2916
US
V. Phone/Fax
- Phone: 501-993-3712
- Fax:
- Phone: 501-993-3712
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HUGO
B
MORAIS
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 501-993-3712