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General NPI Number Information
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NPI Number | 1548362353
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Entity Type | Individual
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Provider Name | ROBERT SCOTT SMITTLE M.S., LPC
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Gender | Male
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1000 SWN DR STE 101
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City | CONWAY
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State | AR
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Zip | 72032-2558
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Country | US
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Telephone | 501-588-2747
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 CHARLOTTE CIR
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City | CONWAY
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State | AR
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Zip | 72034-6046
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Country | US
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Telephone | 501-765-9634
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P1311104
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License Number State | AR
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