Healthcare Provider Details
I. General information
NPI: 1588621494
Provider Name (Legal Business Name): JANIS GHERMAN CLINE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
324 N 2ND ST
ROGERS AR
72756-6647
US
IV. Provider business mailing address
324 N 2ND ST
ROGERS AR
72756-6647
US
V. Phone/Fax
- Phone: 479-986-0566
- Fax: 479-986-0599
- Phone: 479-986-0566
- Fax: 479-986-0599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 1516-C |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 1516-C |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: