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NPI Code Detail

MEDICARE: MRS. JONNA MICHELLE MCCUTCHEON LPC

MEDICARE: MRS. JONNA MICHELLE MCCUTCHEON 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
1101YM0800XMental Health CounselorA1203019AR
2101YM0800XMental Health CounselorP1506074AR
3101YP2500XProfessional CounselorP1506074AR

General Provider Information

NPI Number : 1376818674
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JONNA MICHELLE MCCUTCHEON LPC
Provider Business Mailing Address
First Line : 901 S RAINBOW RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-1637
Country : US
Telephone Number : 479-254-1144
Fax Number : 479-254-1099
Provider Business Practice Location Address
First Line : 901 S RAINBOW RD
Second Line :
City : ROGERS
State : AR
Zip : 72758-1637
Country : US
Telephone Number : 479-254-1144
Fax Number : 479-254-1099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2012
Last Update Date : 03/01/2022

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