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General NPI Number Information
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NPI Number | 1881033538
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Entity Type | Individual
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Provider Name | ALYSSA P PICKETT LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 323 CENTER ST STE 1401
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City | LITTLE ROCK
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State | AR
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Zip | 72201-2605
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Country | US
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Telephone | 430-200-8088
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Fax |
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Provider Business Mailing Address
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Address Line | 323 CENTER ST STE 1401
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City | LITTLE ROCK
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State | AR
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Zip | 72201-2605
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6919-C
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License Number State | AR
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