NPI 1124309018 · live from the CMS NPI Registry
Michael Anthony Cucciare, Ph.D.
Psychologist, Clinical in Little Rock, AR. National Provider Identifier 1124309018, active.
NPI record
| NPI | 1124309018 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 4301 W Markham St # 783, Little Rock, AR 72205 |
| Practice phone | 501-686-8000 |
| Mailing address | 795 Willow Road (152), Menlo Park, CA 94025 |
| Enumerated | September 6, 2011 |
| Last updated | September 10, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical | 103TC0700X | PSY24284 (CA) |
| Psychologist, Clinical primary | 103TC0700X | 13-05aP-PL (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.