Individual provider Active NPI

Julie Ann Stalbaum, LMSW

  • Clinical Social Worker
  • Little Rock, AR
National Provider Identifier
1396462966
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11417-M Issued in AR
Practice address
9101 N Rodney Parham Rd
Little Rock, AR 72205-1685
Phone
(501) 389-8100
NPI assigned
Oct 25, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 11417-M AR Primary

Addresses

Primary practice location

9101 N Rodney Parham Rd
Little Rock, AR 72205-1685

Mailing address

1707 Linwood Dr Ste G1707
Paragould, AR 72450-5364
Phone (870) 604-4455

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
11417-MARMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1396462966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 LINWOOD DR STE G1707",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505364",
            "telephone_number": "870-604-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N RODNEY PARHAM RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722051685",
            "telephone_number": "501-389-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALBAUM",
        "first_name": "JULIE ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "11417-M",
            "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 Oct 25, 2022; 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.