Provider Demographics
NPI:1467947721
Name:NEIGHBORS, AMY (LPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:NEIGHBORS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-3737
Mailing Address - Country:US
Mailing Address - Phone:501-337-6703
Mailing Address - Fax:
Practice Address - Street 1:302 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-3737
Practice Address - Country:US
Practice Address - Phone:501-337-6703
Practice Address - Fax:888-337-2305
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2212020101YP2500X
ARA2105005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR294959719Medicaid