=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407771686
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHENAL FAMILY THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2026
-----------------------------------------------------
Last Update Date | 08/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34 W COLT SQUARE DR STE 1
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72703-2888
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-595-0333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 719 N MALBEC RD
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72704-4012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-318-7041
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MARRIAGE AND FAMILY THERAPY
-----------------------------------------------------
Name | DR. MICHAEL FLOWERS
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 479-841-6101
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------