Provider Demographics
NPI:1114459385
Name:SMALL TALK
Entity Type:Organization
Organization Name:SMALL TALK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASEY
Authorized Official - Middle Name:CATT
Authorized Official - Last Name:SIHVONEN
Authorized Official - Suffix:
Authorized Official - Credentials:M S, CCC-SLP
Authorized Official - Phone:870-636-1610
Mailing Address - Street 1:1712 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-3845
Mailing Address - Country:US
Mailing Address - Phone:870-636-1610
Mailing Address - Fax:880-735-2913
Practice Address - Street 1:310 MID CONTINENT PLZ
Practice Address - Street 2:SUITE 103
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1760
Practice Address - Country:US
Practice Address - Phone:870-636-1610
Practice Address - Fax:870-735-2913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3293235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR195328721Medicaid