Gwendolyn Allen, LCSW

Individual provider Active NPI Clinical Social Worker · Benton, AR

NPI 1124032685 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124032685
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
184-C (AR)
Practice address
6721 Alcoa Rd
Benton, AR 72015-9702
Phone
(501) 257-6726
Fax
(501) 257-6763
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
184-CARMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 184-C AR Yes

Addresses

Primary practice location

6721 Alcoa Rd
Benton, AR 72015-9702

Mailing address

4300 W 7TH St
Little Rock, AR 72205-5446
Phone (501) 257-6726

Other providers in Benton, AR

All providers in Benton, AR · Clinical Social Worker in Arkansas

Sources for this page

Verify at the official NPI Registry.