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Provider Information for 1548362353


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ROBERT SCOTT SMITTLE M.S., LPC


Sex: Male

NPI: 1548362353
Last Updated: 2025-03-03
Certification Date: 2025-03-03

Details

NameValue
NPI1548362353
Enumeration Date2006-09-02
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1125 CHARLOTTE CIR
CONWAY, AR 72034-6046
United States

Phone: 501-765-9634 | Fax:
 
Primary Practice Address 1000 SWN DR STE 101
CONWAY, AR 72032-2558
United States

Phone: 501-588-2747 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDAR170342795
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalARP1311104