Healthcare Provider Details

I. General information

NPI: 1457268419
Provider Name (Legal Business Name): JESSICA KIRKSEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DR
NORTH LITTLE ROCK AR
72114-1707
US

IV. Provider business mailing address

2626 THROCKMORTON ST
DALLAS TX
75219-3321
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number40984
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: