NPI 1275861114 · live from the CMS NPI Registry
Elizabeth Marie Bucolo, M.A.
Psychologist, Clinical in Little Rock, AR. National Provider Identifier 1275861114, active.
NPI record
| NPI | 1275861114 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 1100 N University Ave, Suite 200, Little Rock, AR 72207 |
| Practice phone | 501-686-9300 |
| Enumerated | December 4, 2009 |
| Last updated | January 20, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Counselor, Mental Health | 101YM0800X | — |
| Psychologist, Clinical primary | 103TC0700X | 14-15 LP (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.