Divine Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C1416 Issued in AR

Legal business name

DIVINE THERAPY, LLC

Practice address

209 Roya LN Ste 4
Bryant, AR 72022-2669

Phone

(501) 213-1077

NPI assigned

Aug 11, 2017

Organization subpart

No

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

Authorized official

Name

Julie Fant Childers, LCSW

Title

Director

Phone

(501) 213-1077

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735689600000",
    "number": "1669997599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 ROYA LN STE 4",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720222669",
            "telephone_number": "501-213-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 ROYA LN STE 4",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720222669",
            "telephone_number": "501-213-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-11",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "FANT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "501-213-1077",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "C1416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darshankumar Desai, PHARMD
• Tara D Devaux, MA CCC-SLP
• Tiffany Lynn Dews, MSOTR/L
• Shannon Latrice Dickens
• Nyla Simone Diggins
• Kristen Tierra Dixon
• Laura Beth Dixon
• Kristen Dorsett, M.S., CFY-SLP
• Caleb M Dorsey, PT
• Dr Lewis E Porter Professional Corporation

• Clinical Social Worker in Bryant, AR
• Providers in Bryant, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 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.

Verify at the official NPI Registry.