=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114862208
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVI KUYKENDALL LCSW LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2026
-----------------------------------------------------
Last Update Date | 04/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6646 BERNICE AVE
-----------------------------------------------------
City | SPRINGDALE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72762-5825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-270-3914
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6646 BERNICE AVE
-----------------------------------------------------
City | SPRINGDALE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72762-5825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-270-3914
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LCSW
-----------------------------------------------------
Name | SHEALTIEL KUYKENDALL
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 479-270-3914
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------