Yousef Arfan Fahoum, DRPH, MA, LPE-I

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

12-01E Issued in AR

Practice address

2215 Wildwood Ave Ste 200
Sherwood, AR 72120

Phone

(501) 238-6560

Fax

(501) 904-4452

NPI assigned

May 27, 2010

Last updated

Aug 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Innovative Psychological Services, Inc.

  • Adult Mental Health Clinic/Center
  • Sherwood, AR
  • NPI 1558880153
  NPD Authorized official

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1720307903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241967",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722230037",
            "telephone_number": "501-238-6560",
            "fax_number": "501-904-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 WILDWOOD AVE STE 200",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "72120",
            "telephone_number": "501-238-6560",
            "fax_number": "501-904-4452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10515 W Markham St",
            "address_2": "Suite B5",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722052139",
            "country_code": "US",
            "telephone_number": "501-251-1857",
            "fax_number": "501-225-3294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHOUM",
        "first_name": "YOUSEF",
        "middle_name": "ARFAN",
        "name_prefix": "Dr.",
        "credential": "DRPH, MA, LPE-I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "12-01E",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AR",
            "license": "12-01E",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "12-01E",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AR",
            "license": "12-01E",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "AR",
            "license": "12-01E",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "AR",
            "license": "12-01E",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": "12-01E",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "AR",
            "license": "12-01E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Psychologist in Sherwood, AR
• Providers in Sherwood, AR by specialty
• Health Psychologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.