Organization Active NPI

Flynn Psychological Services, PLLC

  • Clinical Psychologist
  • Little Rock, AR
National Provider Identifier
1538748629
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
FLYNN PSYCHOLOGICAL SERVICES, PLLC
Practice address
10809 Executive Center Dr Ste 105
Little Rock, AR 72211-6020
Phone
(501) 551-5065
NPI assigned
Apr 6, 2021
Last updated
Apr 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Mellany K Flynn, PSY.D.NPI 1548350457
Title
Licensed Clinical Psychologist
Phone
(501) 920-4178

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

10809 Executive Center Dr Ste 105
Little Rock, AR 72211-6020

Mailing address

14601 Woodcreek Dr
Little Rock, AR 72211-2941
Phone (501) 920-4178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210419001839 AR Part B Supplier - Clinic/Group Practice 9436567146 Receives reassigned benefits from 1 practitioner
Practice locations: Little Rock, AR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1538748629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 WOODCREEK DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112941",
            "telephone_number": "501-920-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10809 EXECUTIVE CENTER DR STE 105",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722116020",
            "telephone_number": "501-551-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLYNN PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "MELLANY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "501-920-4178",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "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 Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.