Active NPI
Gwendolyn Staten
- Behavior Technician
- Little Rock, AR
National Provider Identifier
1639922941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1900 Aldersgate Rd
Little Rock, AR 72205-6620 - Phone
- (501) 821-5459
- NPI assigned
- Apr 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1900 Aldersgate Rd
Little Rock, AR 72205-6620
Mailing address
PO Box 251970
Little Rock, AR 72225-1970
Phone (501) 666-8686
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755734400000",
"number": "1639922941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 251970",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722251970",
"telephone_number": "501-666-8686",
"fax_number": "501-660-6830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 ALDERSGATE RD",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722056620",
"telephone_number": "501-821-5459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STATEN",
"first_name": "GWENDOLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-08",
"last_updated": "2025-08-21",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
- State of Arkansas (AR Dept of Health & Human Services Home Health)
- State of Arkansas (Ar Mental Health SVCS)
- State of Arkansas (Arkansas State Hospital)
- State of Arkansas
- State of the Heart Counseling Services, Inc.
- Madolyn Claire Statler, LCSW
- Alyssa Staton, M.S., CCC-SLP
- Steady Pace Psychiatry LLC
- Melia Stearns, DNAP, CRNA
- Daniel Steed, MHPP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.