Healthcare Provider Details

I. General information

NPI: 1013583509
Provider Name (Legal Business Name): CAIDEN LEYON BOYCE MCFADDEN PLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 07/02/2024
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MORGAN ST STE 8
PARAGOULD AR
72450-3949
US

IV. Provider business mailing address

1815 PLEASANT GROVE ROAD
JONESBORO AR
72405-7870
US

V. Phone/Fax

Practice location:
  • Phone: 870-335-9483
  • Fax: 870-335-9487
Mailing address:
  • Phone: 870-933-6886
  • Fax: 870-870-3361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: