Provider Demographics
NPI:1588295075
Name:LES SMITH PA
Entity type:Organization
Organization Name:LES SMITH PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:EMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-970-0386
Mailing Address - Street 1:700 S SCHILLER ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-4735
Mailing Address - Country:US
Mailing Address - Phone:501-313-2678
Mailing Address - Fax:501-603-9497
Practice Address - Street 1:700 S SCHILLER ST STE 300
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-4735
Practice Address - Country:US
Practice Address - Phone:501-313-2678
Practice Address - Fax:501-603-9497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LES SMITH PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-03
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145039001Medicaid