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General NPI Number Information
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NPI Number | 1992164263
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Entity Type | Individual
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Provider Name | CATHY LYNN STATON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 320 OUACHITA AVE STE 210
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City | HOT SPRINGS NATIONAL PARK
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State | AR
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Zip | 71901-5189
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Country | US
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Telephone | 501-617-5678
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Fax | 501-701-4014
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Provider Business Mailing Address
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Address Line | 100 TRIVISTA RIGHT ST
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City | HOT SPRINGS NATIONAL PARK
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State | AR
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Zip | 71901-7502
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Country | US
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Telephone | 501-617-5678
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 15-05AP-PL
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 17-04P
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License Number State | AR
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