Rachel L Fazio, PSY.D.
Individual provider Active NPI Clinical Psychologist · Little Rock, AR
NPI 1356589360 · NPPES record last updated Jun 3, 2020
Key facts
- NPI
- 1356589360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1277 (NM)
- Practice address
- 400 W Capitol Ave Ste 1700
Little Rock, AR 72201-3438 - Phone
- (501) 301-4643
- NPI assigned
- Jan 29, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009001340 | MO | MD | Mental Health Counselor |
| C.0600552 | OH | MD | Mental Health Counselor |
| 18-11P | AR | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.0600552 | OH | |
| Mental Health Counselor | 101YM0800X | 2009001340 | MO | |
| Clinical Psychologist | 103TC0700X | 18-11P | AR | |
| Clinical Psychologist | 103TC0700X | 1277 | NM | Yes |
Addresses
Primary practice location
400 W Capitol Ave Ste 1700
Little Rock, AR 72201-3438
Mailing address
400 W Capitol Ave Ste 1700
Little Rock, AR 72201-3438
Phone (501) 301-4643
Other practice location 1
125 Wellness Way
Hot Springs, AR 71913-6478
Phone (501) 624-7111
Other providers in Little Rock, AR
- Sue Faulkner
- Ron E Faupel
- Amanda Michelle Faust
- Saima Fawad
- Nicholas Jay Fazio
- Yama N Fazli
- FC of Arkansas Inc
- Katelyn Brooke Feemster
- Charles Feild
- Shariesa Renae Feimster
All providers in Little Rock, AR · Clinical Psychologist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.