Healthcare Provider Details

I. General information

NPI: 1114131539
Provider Name (Legal Business Name): ANDREW CHARLES SCHUBERT LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 HIGHWAY 62 E
MOUNTAIN HOME AR
72653-3260
US

IV. Provider business mailing address

759 HIGHWAY 62 E
MOUNTAIN HOME AR
72653-3260
US

V. Phone/Fax

Practice location:
  • Phone: 870-594-8387
  • Fax:
Mailing address:
  • Phone: 870-594-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1529-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: