Healthcare Provider Details

I. General information

NPI: 1497343230
Provider Name (Legal Business Name): THE PHARM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 EVERGREEN DR STE B
LITTLE ROCK AR
72205-1757
US

IV. Provider business mailing address

909 GREGORY ST
JACKSONVILLE AR
72076-3015
US

V. Phone/Fax

Practice location:
  • Phone: 501-596-3396
  • Fax:
Mailing address:
  • Phone: 501-412-0281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA DANIELLE CHAPPELL
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 501-412-0281