Provider Demographics
NPI:1326647918
Name:COCO PSYCHIATRIC SERVICES PLLC
Entity Type:Organization
Organization Name:COCO PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACKARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COCO
Authorized Official - Suffix:
Authorized Official - Credentials:MNSC, APRN, PMHNP-BC
Authorized Official - Phone:870-819-1657
Mailing Address - Street 1:115 BELLA ROSA PL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4771
Mailing Address - Country:US
Mailing Address - Phone:870-819-1657
Mailing Address - Fax:
Practice Address - Street 1:10801 EXECUTIVE CENTER DR STE 303
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4303
Practice Address - Country:US
Practice Address - Phone:501-506-1587
Practice Address - Fax:501-298-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty