Healthcare Provider Details

I. General information

NPI: 1972417616
Provider Name (Legal Business Name): WILLIAM STONE LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LILE CT STE 200
LITTLE ROCK AR
72205-6240
US

IV. Provider business mailing address

1310 W MAIN ST STE 201
RUSSELLVILLE AR
72801-2803
US

V. Phone/Fax

Practice location:
  • Phone: 501-397-1495
  • Fax: 501-397-1495
Mailing address:
  • Phone: 479-968-2001
  • Fax: 479-219-9425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA2609013
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: