MEDICARE: CENTRAL ARKANSAS PSYCHOLOGICAL SERVICES

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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1487205357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL ARKANSAS PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	523 N UNIVERSITY AVE
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-2916
Country	:	US
Telephone Number	:	501-993-3712
Fax Number	:

Provider Business Practice Location Address
First Line	:	523 N UNIVERSITY AVE
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-2916
Country	:	US
Telephone Number	:	501-993-3712
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. HUGO B MORAIS
Credential	:	PH.D.
Telephone Number	:	501-993-3712

Provider Enumeration Date	:	09/23/2019
Last Update Date	:	09/23/2019

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