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NPI Code Detail

MEDICARE: CHENAL FAMILY THERAPY, PLC

MEDICARE: CHENAL FAMILY THERAPY, PLC
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
1106H00000XMarriage & Family Therapist
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1356604219
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHENAL FAMILY THERAPY, PLC
Provider Business Mailing Address
First Line : 10311 W MARKHAM ST
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-2135
Country : US
Telephone Number : 501-781-2230
Fax Number : 888-816-7916
Provider Business Practice Location Address
First Line : 10311 W MARKHAM ST
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-2135
Country : US
Telephone Number : 501-781-2230
Fax Number : 888-816-7916
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MR. KENNETH ANDREW CLARK II
Credential : LMFT
Telephone Number : 501-781-2230
Provider Enumeration Date : 06/16/2012
Last Update Date : 07/07/2023

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Directions to “CHENAL FAMILY THERAPY, PLC ” Practice Location

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