Healthcare Provider Details
I. General information
NPI: 1114869492
Provider Name (Legal Business Name): MID STATE COUNSELING AND RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1920 MAIN ST STE 229
NORTH LITTLE ROCK AR
72114-2875
US
IV. Provider business mailing address
1920 MAIN ST
NORTH LITTLE ROCK AR
72114-2872
US
V. Phone/Fax
- Phone: 501-351-3528
- Fax:
- Phone: 501-351-3528
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMUEL
EDWARD
ADKINS
Title or Position: OWNER
Credential: LCSW
Phone: 501-351-3528