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NPI 1093624843

NPI 1093624843 : SYCAMORE MENTAL HEALTH & WELLNESS, PLLC : MOUNTAIN HOME, AR

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General NPI Number Information
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    NPI Number           |    1093624843
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    Entity Type          |    Organization 
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    Legal Business Name  |    SYCAMORE MENTAL HEALTH & WELLNESS, PLLC 
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Dates
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    Enumeration Date     |    09/04/2026
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    Last Update Date     |    09/06/2026
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Provider Practice Location Address
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    Address Line         |    701 SOUTH ST STE 100 
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    City                 |    MOUNTAIN HOME
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    State                |    AR
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    Zip                  |    72653-4452
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    Country              |    US
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    Telephone            |    501-604-6355
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 602 
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    City                 |    MABELVALE
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    State                |    AR
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    Zip                  |    72103-0602
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGING MEMBER
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    Name                 |     JULIE  HARRIS 
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    Credential           |    
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    Telephone            |    501-604-6355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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