| Family Psychological Center | |
|
623 N Walnut St Harrison AR 72601-3617 | |
| (870) 743-6225 | |
| (870) 743-6006 |
| Full Name | Family Psychological Center |
|---|---|
| Speciality | Psychologist |
| Location | 623 N Walnut St, Harrison, Arkansas |
| Authorized Official Name and Position | William Charles Nichols (DIRECTOR/CEO) |
| Authorized Official Contact | 8707436225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Psychological Center 623 N Walnut St Harrison AR 72601-3617 Ph: (870) 743-6225 | Family Psychological Center 623 N Walnut St Harrison AR 72601-3617 Ph: (870) 743-6225 |
| NPI Number | 1033293733 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 01/03/2011 |
| Medicare PECOS PAC ID | 6305005455 |
|---|---|
| Medicare Enrollment ID | O20120308000308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033293733 | NPI | - | NPPES |
| 148984744 | Medicaid | AR | |
| 5C757 | Other | AR | BC/BS PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 00-12P (Arkansas) | Primary |
| Provider Name | William Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215994876 PECOS PAC ID: 2769640176 Enrollment ID: I20120308000762 |
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