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KYLE CLARK ANDERSON
>> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1114063765
Individual Registrant: KYLE CLARK ANDERSON
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
500 E MAIN ST SUITE 310 BATESVILLE, AR 72501-4660 US
Tel: 870-569-4890 Fax: --
Tel: 870-569-4890 Fax: --
Contact information for business:
1600 ALDERSGATE RD SUITE 200 LITTLE ROCK, AR 72205-6676 US
Tel: 501-661-0720 Fax: --
Tel: 501-661-0720 Fax: --
Registration Information:
NPI: 1114063765
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101Y00000X | Behavioral Health & Social Service Providers Counselor | AR | A1608108 |
| N | 171M00000X | Other Service Providers Case Manager/Care Coordinator | AR | |
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor | AR | P1810134 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
