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General NPI Number Information
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NPI Number | 1831469956
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Entity Type | Organization
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Legal Business Name | CHANDA CAMDEN, LCSW, P.A.
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 401 W CAPITOL AVE SUITE 301
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City | LITTLE ROCK
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State | AR
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Zip | 72201-3421
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Country | US
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Telephone | 501-975-0009
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Fax | 501-975-0009
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Provider Business Mailing Address
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Address Line | 401 W CAPITOL AVE SUITE 301
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City | LITTLE ROCK
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State | AR
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Zip | 72201-3421
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Country | US
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Telephone | 501-975-0009
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Fax | 501-975-0009
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | MRS. CHANDA DANIELLE CAMDEN
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Credential | LCSW
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Telephone | 501-975-0009
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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 | 2437-C
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License Number State | AR
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