Green, Joan Jackson

Green, Joan Jackson is an individual health care provider with primary practice located at 4960 Springhouse Dr , Springdale AR 72762-7261. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Green, Joan Jackson can be contacted via phone (479) 750-2020.

Contact Information

Primary practice address
4960 Springhouse Dr Springdale AR 72762-7261
Phone: (479) 750-2020
Fax: (479) 872-1883
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X P9911024 Arkansas

Profile Details

NPI number 1811930209
LBN Legal business name Green, Joan Jackson
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Jul 8th, 2007 - about 17 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 1811930209 NPPES
Arkansas Other 5X656 BLUE SHIELD PROVIDER #

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