Kerry Underwood

Organization Active NPI Marriage & Family Therapist · Fort Smith, AR

NPI 1336512979 · NPPES record last updated Mar 9, 2017

Key facts

NPI
1336512979
Entity type
Organization (NPI type 2)
Primary specialty
Marriage & Family Therapist 106H00000X
License
A1101002 (AR)
Legal business name
KERRY UNDERWOOD
Practice address
5401 Rogers Ave
Suite 200
Fort Smith, AR 72903-3745
Phone
(479) 226-8403
Fax
(479) 250-0334
NPI assigned
Nov 4, 2015
Organization subpart
No

Authorized official

Name
Dr. Mary Jeppsen
Title
Partner
Phone
(479) 226-8403

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Fresh Roots Family Counseling (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
106H00000X A1101002 AR Yes

Addresses

Primary practice location

5401 Rogers Ave
Suite 200
Fort Smith, AR 72903-3745

Mailing address

5401 Rogers Ave
Suite 200
Fort Smith, AR 72903-3745
Phone (479) 226-8403

Other providers in Fort Smith, AR

All providers in Fort Smith, AR · Marriage & Family Therapist in Arkansas

Sources for this page

Verify at the official NPI Registry.