Healthcare Provider Details

I. General information

NPI: 1760742373
Provider Name (Legal Business Name): JAMES R MONEYPENNY PHD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 W MARKHAM ST SUITE 305
LITTLE ROCK AR
72205-2453
US

IV. Provider business mailing address

8500 W MARKHAM ST SUITE 305
LITTLE ROCK AR
72205-2453
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-7044
  • Fax:
Mailing address:
  • Phone: 501-227-7044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberAR 82-15P
License Number StateAR

VIII. Authorized Official

Name: JAMES RUSSELL MONEYPENNY
Title or Position: PSYCHOLOGIST
Credential: PH.D
Phone: 501-227-7044