Ennes, Kathy Alene

Ennes, Kathy Alene is an individual health care provider with primary practice located at 60 W Sunbridge Dr , Fayetteville AR 72703-1822. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ennes, Kathy Alene can be contacted via phone (479) 695-1240.

Contact Information

Primary practice address
60 W Sunbridge Dr Fayetteville AR 72703-1822
Phone: (479) 695-1240
Fax: (479) 750-4843
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1809-C Arkansas

Profile Details

NPI number 1053353003
LBN Legal business name Ennes, Kathy Alene
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053353003 NPPES
Arkansas Other 5X658 BLUE SHIELD PROVIDER #

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