Provider Demographics
NPI:1992844310
Name:SPOONER, REBECCA (LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SPOONER
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 1:165 PRUETT RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-9791
Mailing Address - Country:US
Mailing Address - Phone:501-733-9872
Mailing Address - Fax:501-666-8198
Practice Address - Street 1:101 N WOODROW ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4341
Practice Address - Country:US
Practice Address - Phone:501-265-0046
Practice Address - Fax:501-265-0057
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1101005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health