Healthcare Provider Details

I. General information

NPI: 1538748629
Provider Name (Legal Business Name): FLYNN PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10809 EXECUTIVE CENTER DR STE 105
LITTLE ROCK AR
72211-6020
US

IV. Provider business mailing address

14601 WOODCREEK DR
LITTLE ROCK AR
72211-2941
US

V. Phone/Fax

Practice location:
  • Phone: 501-551-5065
  • Fax:
Mailing address:
  • Phone: 501-920-4178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MELLANY K FLYNN
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 501-920-4178