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General NPI Number Information
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NPI Number | 1386433225
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Entity Type | Individual
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Provider Name | HEIDI JOY METHVIN LAC
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Gender | Female
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 2525 W NEW HOPE RD
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City | ROGERS
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State | AR
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Zip | 72758-1351
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Country | US
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Telephone | 479-366-5136
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 S 48TH ST
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City | ROGERS
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State | AR
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Zip | 72758-5251
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Country | US
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Telephone | 213-446-0011
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A2502016
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License Number State | AR
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