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NPI 1972967412 · live from the CMS NPI Registry

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Social Worker, Clinical in Bentonville, AR. National Provider Identifier 1972967412, active.

NPI record

NPI1972967412 Type 2 · organization
StatusActive
Primary specialtySocial Worker, Clinical 1041C0700X
Practice location809 Se 28th St Ste 1, Bentonville, AR 72712
Practice phone479-876-8626
EnumeratedApril 11, 2016
Last updatedAugust 13, 2025
Authorized officialValerie Perry, Owner

Taxonomies and licenses

TaxonomyCodeLicense
Social Worker, Clinical primary1041C0700XC-1018 (AR)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.