Healthcare Provider Details

I. General information

NPI: 1831955392
Provider Name (Legal Business Name): AMENA RACHEL WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S 19TH ST STE D
ROGERS AR
72758-1123
US

IV. Provider business mailing address

201 S 19TH ST STE D
ROGERS AR
72758-1123
US

V. Phone/Fax

Practice location:
  • Phone: 479-343-9393
  • Fax:
Mailing address:
  • Phone: 479-343-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: