Healthcare Provider Details

I. General information

NPI: 1346776374
Provider Name (Legal Business Name): JAIME STARLING LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 WEST 2ND ST.
LONOKE AR
72086
US

IV. Provider business mailing address

3601 RICHARDS RD
NORTH LITTLE ROCK AR
72117-2954
US

V. Phone/Fax

Practice location:
  • Phone: 501-676-3151
  • Fax:
Mailing address:
  • Phone: 501-221-1843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA1809126
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2109016
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: