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General NPI Number Information
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NPI Number | 1881299675
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Entity Type | Organization
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Legal Business Name | HOPE & HEALING OF NEA PLLC
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 2701 S CARAWAY RD STE B1
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City | JONESBORO
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State | AR
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Zip | 72401-7336
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Country | US
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Telephone | 870-926-5710
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Fax |
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Provider Business Mailing Address
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Address Line | 680 COUNTY ROAD 793
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City | BROOKLAND
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State | AR
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Zip | 72417-8778
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Country | US
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Telephone | 870-926-5710
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Fax | 870-292-3431
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Authorized Official
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Title or Position | OWNER
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Name | MR. LARRY LUCAS LEWALLEN
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Credential | LCSW
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Telephone | 870-926-5710
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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