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General NPI Number Information
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NPI Number | 1225997836
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Entity Type | Organization
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Legal Business Name | CHAYIM KAVANAH WELLNESS LLC
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 505 W PERSHING BLVD STE C
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-2157
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Country | US
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Telephone | 501-247-3656
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 94052
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72190-4052
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Country | US
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Telephone | 501-247-3656
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAREN RENA' MOORE
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Credential | PHD
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Telephone | 501-247-3656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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