NPI 1649866203 · live from the CMS NPI Registry
Ark Academy, LLC
Psychologist, Clinical Child & Adolescent in Jackson, TN. National Provider Identifier 1649866203, active.
NPI record
| NPI | 1649866203 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical Child & Adolescent 103TC2200X |
| Practice location | 106 Stonebridge Blvd, Jackson, TN 38305 |
| Practice phone | 731-300-4275 |
| Enumerated | December 17, 2020 |
| Last updated | May 27, 2022 |
| Authorized official | Stephen Collier, Authorized Official |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical Child & Adolescent primary | 103TC2200X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.