Marlyn Chakwera

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

202329 Issued in AR

Practice address

4301 W Markham St # 568
Little Rock, AR 72205-7101

Phone

(501) 320-7302

NPI assigned

Jul 26, 2024

Last updated

Aug 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marlyn Chimombo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1396574679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 S ARCH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722061343",
            "telephone_number": "630-812-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 568",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-320-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAKWERA",
        "first_name": "MARLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "202329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLYN",
            "last_name": "CHIMOMBO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kiran Chakka
• Mangaraju Chakka, M.D.
• Indranil Chakraborty, MD
• Srivally Chakravarthula, MBBS,MD
• Rohan Kiran Chakravorty
• Lina Chalak, MD
• Jillian Marie Chalfant
• Lindsay Chalmers, ANP
• Stacie Lee Chalupka, LCSW
• Bethany Chamberlain

• Clinical Psychologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.