Individual provider Active NPI

Kaitlin Rheane' Parker, LCSW

  • Clinical Social Worker
  • Little Rock, AR
National Provider Identifier
1336877307
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12167-C Issued in AR
Practice address
12921 Cantrell Rd Ste 105
Little Rock, AR 72223-1798
Phone
(501) 891-5492
NPI assigned
Aug 9, 2022
Last updated
Jul 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12167-C AR Primary

Addresses

Primary practice location

12921 Cantrell Rd Ste 105
Little Rock, AR 72223-1798

Mailing address

9805B Jacksonville Cato Rd # RS
Sherwood, AR 72120-1952
Phone (501) 916-0294

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12167-CARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics Plus Counseling & Diagnostics LLC CurrentSince Aug 14, 2022 Accepting new patients

Locations

12921 Cantrell Rd
Ste 105
Little Rock, AR 72223
Phone (501) 891-5492

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1336877307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9805B JACKSONVILLE CATO RD # RS",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721201952",
            "telephone_number": "501-916-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12921 CANTRELL RD STE 105",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722231798",
            "telephone_number": "501-891-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KAITLIN",
        "middle_name": "RHEANE'",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "12167-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.