Provider Demographics
NPI:1285159327
Name:PANNELL, JOCELYN (LMSW)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:PANNELL
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:PO BOX 1509
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-1509
Mailing Address - Country:US
Mailing Address - Phone:501-505-4020
Mailing Address - Fax:505-859-0060
Practice Address - Street 1:2110 BENTON ST
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6920
Practice Address - Country:US
Practice Address - Phone:501-505-4020
Practice Address - Fax:501-859-0060
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8835-M104100000X
AR8835-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker