Prestridge, Tara Lynn Thomasson

Prestridge, Tara Lynn Thomasson is an individual health care provider with primary practice located at 1846 N Best Friend Ln , Fayetteville AR 72704-6520. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Prestridge, Tara Lynn Thomasson can be contacted via phone (501) 624-7111.

Contact Information

Primary practice address
1846 N Best Friend Ln Fayetteville AR 72704-6520
Phone: (501) 624-7111
Fax: (501) 620-5109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X A0803025 Arkansas
Behavioral Health & Social Service Providers / Professional 101YP2500X P1110085 Arkansas

Profile Details

NPI number 1346455169
LBN Legal business name Prestridge, Tara Lynn Thomasson
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2007
Last updated Mar 8th, 2018 - about 6 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 1346455169 NPPES
Arkansas MEDICAID 116399726

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