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General NPI Number Information
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NPI Number | 1285754960
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Entity Type | Individual
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Provider Name | THOMASENA LAMENA MCNUTT LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 4700W COMMERCIAL DR B
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-8089
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Country | US
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Telephone | 501-727-3100
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Fax | 501-727-3100
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Provider Business Mailing Address
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Address Line | 4700 W COMMERCIAL DR SUITE B1
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7068
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Country | US
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Telephone | 501-727-3100
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Fax | 501-727-3100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2058-C
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW61221460
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License Number State | WA
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