Healthcare Provider Details

I. General information

NPI: 1194009431
Provider Name (Legal Business Name): REBECCA SHEA WOODALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 10/06/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 UNIVERSITY DR SUITE 201
MONTICELLO AR
71655-0002
US

IV. Provider business mailing address

342 HIGHWAY 425 S
MONTICELLO AR
71655-4612
US

V. Phone/Fax

Practice location:
  • Phone: 870-224-0109
  • Fax: 855-926-7383
Mailing address:
  • Phone: 870-942-3000
  • Fax: 870-942-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: