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NPI Code Detail

MEDICARE: DAVID DEPEW LPC

MEDICARE: DAVID DEPEW LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorP2307003AR

General Provider Information

NPI Number : 1013713130
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID DEPEW LPC
Provider Business Mailing Address
First Line : 15722 LITTLE BEAVER LN
Second Line :
City : ROGERS
State : AR
Zip : 72756-2609
Country : US
Telephone Number : 479-335-4029
Fax Number :
Provider Business Practice Location Address
First Line : 1051 W PLEASANT GROVE RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-8052
Country : US
Telephone Number : 479-335-4029
Fax Number : 479-659-3673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2025
Last Update Date : 02/20/2025

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