| The Family Center | |
|
11215 Hermitage Road Suite 200 Little Rock AR 72211 | |
| (501) 221-2811 | |
| (501) 221-2812 |
| Full Name | The Family Center |
|---|---|
| Speciality | Counselor |
| Location | 11215 Hermitage Road, Little Rock, Arkansas |
| Authorized Official Name and Position | Lesa Lackey Doan (OWNER) |
| Authorized Official Contact | 5012212811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Family Center 11215 Hermitage Road Suite 200 Little Rock AR 72211 Ph: (501) 221-2811 | The Family Center 11215 Hermitage Road Suite 200 Little Rock AR 72211 Ph: (501) 221-2811 |
| NPI Number | 1942394564 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2062537442 |
|---|---|
| Medicare Enrollment ID | O20100909000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942394564 | NPI | - | NPPES |
| 1033147111 | Other | AR | NPI INDIVIDUAL IDENTIFIER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | C-574 (Arkansas) | Primary |
| Provider Name | Lesa L Doan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033147111 PECOS PAC ID: 4284759663 Enrollment ID: I20100909000604 |
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