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General NPI Number Information
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NPI Number | 1962622969
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Entity Type | Organization
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Legal Business Name | FIT MIND INCORPORATED
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 600 S. MCCKINLEY ST. STE 304
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-231-6443
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Fax | 501-280-0993
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Provider Business Mailing Address
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Address Line | 600 S. MCCKINLEY ST. STE 304
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-231-6443
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Fax | 501-280-0993
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAMEKA L LANCASTER
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Credential | LCSW, LADC
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Telephone | 501-231-6443
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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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