Provider Demographics
NPI:1306297510
Name:FLOWERS, THERESA (PHD, LCSW)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 W MARKHAM ST STE I6
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2283
Mailing Address - Country:US
Mailing Address - Phone:501-503-1154
Mailing Address - Fax:
Practice Address - Street 1:10515 W MARKHAM ST STE I6
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2283
Practice Address - Country:US
Practice Address - Phone:501-503-1154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8051-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical