Healthcare Provider Details

I. General information

NPI: 1093624843
Provider Name (Legal Business Name): SYCAMORE MENTAL HEALTH & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SOUTH ST STE 100
MOUNTAIN HOME AR
72653-4452
US

IV. Provider business mailing address

PO BOX 602
MABELVALE AR
72103-0602
US

V. Phone/Fax

Practice location:
  • Phone: 501-604-6355
  • Fax: 501-476-4404
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: JULIE HARRIS
Title or Position: MANAGING MEMBER
Credential:
Phone: 501-604-6355