Provider Demographics
NPI:1225475551
Name:SPYTMA-WOODS, ALEISHA JOYCE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEISHA
Middle Name:JOYCE
Last Name:SPYTMA-WOODS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 ENTERPRISE DR
Mailing Address - Street 2:STE 300
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-8982
Mailing Address - Country:US
Mailing Address - Phone:479-717-7626
Mailing Address - Fax:479-717-7627
Practice Address - Street 1:515 ENTERPRISE DR
Practice Address - Street 2:STE 300
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8982
Practice Address - Country:US
Practice Address - Phone:479-717-7626
Practice Address - Fax:479-717-7627
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7795-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical