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General NPI Number Information
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NPI Number | 1831439983
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Entity Type | Individual
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Provider Name | ANDREA BYNUM LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 124 W CAPITOL AVE STE 1925
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City | LITTLE ROCK
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State | AR
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Zip | 72201-3704
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Country | US
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Telephone | 501-247-1461
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Fax | 501-480-5181
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Provider Business Mailing Address
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Address Line | PO BOX 22511
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City | LITTLE ROCK
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State | AR
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Zip | 72221-2511
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Country | US
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Telephone | 501-960-8195
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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 | AR
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