Provider Demographics
NPI:1275904963
Name:DAVIS, TOMMIE FLOWERS (LCSW, ACSW, LADAC, A)
Entity Type:Individual
Prefix:MS
First Name:TOMMIE
Middle Name:FLOWERS
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW, ACSW, LADAC, A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 W 12TH ST
Mailing Address - Street 2:LITTLE ROCK
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-2139
Mailing Address - Country:US
Mailing Address - Phone:501-663-4774
Mailing Address - Fax:501-663-7228
Practice Address - Street 1:3604 W 12TH ST
Practice Address - Street 2:LITTLE ROCK
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2139
Practice Address - Country:US
Practice Address - Phone:501-663-4774
Practice Address - Fax:501-663-7228
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA065101YA0400X
AR646-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)