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General NPI Number Information
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NPI Number | 1427872696
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Entity Type | Organization
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Legal Business Name | MAYWOOD COUNSELING PLLC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 1 MAYWOOD DR
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City | LITTLE ROCK
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State | AR
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Zip | 72223-9735
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Country | US
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Telephone | 501-559-3150
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Fax |
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Provider Business Mailing Address
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Address Line | 18521 CANTRELL
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City | LITTLE ROCK
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State | AR
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Zip | 72223
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Country | US
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Telephone | 501-559-3150
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Fax |
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Authorized Official
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Title or Position | INCORPORATOR/ ORGANIZER
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Name | LAUREN RUTHVEN
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Credential | LCSW
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Telephone | 501-559-3150
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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 |
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License Number State |
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