Provider Demographics
NPI:1154408698
Name:BRYANT, FLECIA GRETA (LMSW)
Entity type:Individual
Prefix:MS
First Name:FLECIA
Middle Name:GRETA
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 JONES ST
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-9415
Mailing Address - Country:US
Mailing Address - Phone:870-246-1109
Mailing Address - Fax:870-245-2566
Practice Address - Street 1:829 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-2637
Practice Address - Country:US
Practice Address - Phone:501-332-4400
Practice Address - Fax:501-332-4403
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1548-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical