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General NPI Number Information
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NPI Number | 1821305186
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Entity Type | Organization
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Legal Business Name | FORT SMITH BEHAVIORAL HEALTH INC
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 1620 S 46TH ST
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City | FORT SMITH
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State | AR
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Zip | 72903-3129
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Country | US
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Telephone | 479-494-7000
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Fax | 479-494-7889
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Provider Business Mailing Address
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Address Line | 1620 S 46TH ST 1620 S 46TH STREET
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City | FORT SMITH
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State | AR
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Zip | 72903-3129
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Country | US
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Telephone | 479-494-7889
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Fax | 479-494-7890
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | DR. STEPHEN DOUGLAS CHIOVOLONI
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Credential | DSW, LCSW
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Telephone | 479-494-7889
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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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