Healthcare Provider Details

I. General information

NPI: 1861765984
Provider Name (Legal Business Name): AUTUMN OSMENT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 HIGHWAY 69 BLVD
TRUMANN AR
72472-2144
US

IV. Provider business mailing address

9701 W MARKHAM ST
LITTLE ROCK AR
72205-2123
US

V. Phone/Fax

Practice location:
  • Phone: 501-373-4320
  • Fax: 870-770-7177
Mailing address:
  • Phone: 501-737-4320
  • Fax: 870-770-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1503015
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: