Provider Demographics
NPI:1013020494
Name:EKDAHL, MICHAEL (LPE-I)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:EKDAHL
Suffix:
Gender:M
Credentials:LPE-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 251970
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1970
Mailing Address - Country:US
Mailing Address - Phone:501-666-8686
Mailing Address - Fax:501-660-6830
Practice Address - Street 1:5800 WEST 10TH STREET
Practice Address - Street 2:SUITE 600
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1761
Practice Address - Country:US
Practice Address - Phone:501-660-6817
Practice Address - Fax:501-660-6825
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR95-03EI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional