Elizabeth Pulliam, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

06-27P Issued in AR

Practice address

1 Children'S Way # 653
Little Rock, AR 72202-3510

Phone

(501) 364-1100

Fax

(501) 526-6562

NPI assigned

Sep 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1669572202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDREN'S WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100",
            "fax_number": "501-526-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDREN'S WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-1100",
            "fax_number": "501-526-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "ELIZABETH",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "06-27P",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AR",
            "license": "06-27P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "06090017700",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00412563",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162693719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pulaski Heights Wellness Clinic, PLLC
• Pulaski Injury & Rehab Center, Inc.
• Tom Spec Pullam, RPH
• Jodi Allison Pullen, OTR/L
• Caden A Pulliam
• Jon Pulliam, MHPP
• Pulmonary Associates PA
• Pultro & Palmer, P.a.
• Pultro and Palmer, P.a.
• Ashley L Pultro, M.S., CCC-SLP

• 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 Oct 16, 2009; 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.