Healthcare Provider Details

I. General information

NPI: 1689724064
Provider Name (Legal Business Name): DONNA L MORSE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 DOGWOOD HOLLOW RD
MOUNTAIN VIEW AR
72560-7942
US

IV. Provider business mailing address

PO BOX 1589
BENTON AR
72018-1589
US

V. Phone/Fax

Practice location:
  • Phone: 501-315-3344
  • Fax:
Mailing address:
  • Phone: 501-303-3105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5000
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8373-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: