Provider Demographics
NPI:1912136045
Name:HEAD, WILLIAM JOE (LPE)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOE
Last Name:HEAD
Suffix:
Gender:M
Credentials:LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ALDERSGATE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6614
Mailing Address - Country:US
Mailing Address - Phone:870-318-8487
Mailing Address - Fax:
Practice Address - Street 1:1600 ALDERSGATE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6614
Practice Address - Country:US
Practice Address - Phone:870-318-8487
Practice Address - Fax:501-325-7938
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR92-08 LPE-I101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor