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General NPI Number Information
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NPI Number | 1548469059
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Entity Type | Individual
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Provider Name | JUSTIN M LAFFOON LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 21 BRIDGEWAY RD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72113-9516
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Country | US
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Telephone | 501-687-8633
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Fax | 501-771-8509
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Provider Business Mailing Address
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Address Line | 2318 S SUMMIT ST
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City | LITTLE ROCK
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State | AR
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Zip | 72206-1764
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Country | US
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Telephone | 501-686-8145
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Fax | 501-526-6280
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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 | 3639-C
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License Number State | AR
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