| Magnolia Mental Health Clinic Pllc | |
|
1061 Front St Conway AR 72032-4305 | |
| (501) 209-3362 | |
| Not Available |
| Full Name | Magnolia Mental Health Clinic Pllc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 1061 Front St, Conway, Arkansas |
| Authorized Official Name and Position | Alisha Mccool (OWNER/PMHNP) |
| Authorized Official Contact | 5012093362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Mental Health Clinic Pllc 1061 Front St Conway AR 72032-4305 Ph: (501) 209-3362 | Magnolia Mental Health Clinic Pllc 1061 Front St Conway AR 72032-4305 Ph: (501) 209-3362 |
| NPI Number | 1972376309 |
|---|---|
| Provider Enumeration Date | 11/07/2023 |
| Last Update Date | 08/22/2024 |
| Certification Date | 08/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972376309 | NPI | - | NPPES |
| 1366033749 | Other | AR | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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