Funkhouser, Reagan
Funkhouser, Reagan is an sole proprietor health care provider with primary practice located at 1108 Poplar Pl , Rogers AR 72756-4249. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Funkhouser, Reagan can be contacted via phone (479) 372-6464.Contact Information
Primary practice address
1108 Poplar Pl
Rogers AR 72756-4249
Phone: (479) 372-6464
Fax: (479) 372-6460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1958-C | Arkansas |
Profile Details
| NPI number | 1639339534 |
|---|---|
| LBN Legal business name | Funkhouser, Reagan |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2008 |
| Last updated | May 5th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639339534 | NPPES |
| Arkansas | MEDICAID | 237237719 |
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