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General NPI Number Information
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NPI Number | 1568848489
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Entity Type | Individual
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Provider Name | SAMANTHA BUSHEY
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Gender | Female
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 1111 S BOWMAN RD STE B4
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3766
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Country | US
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Telephone | 501-747-1071
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Fax | 501-747-1186
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Provider Business Mailing Address
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Address Line | 9101 N RODNEY PARHAM RD STE B
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City | LITTLE ROCK
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State | AR
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Zip | 72205-1685
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Country | US
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Telephone | 501-389-8100
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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 |
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License Number State |
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