Provider Demographics
NPI:1366645905
Name:NIMMO, LEE ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:LEE
Middle Name:ANN
Last Name:NIMMO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:ANN
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15370 TULSA DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:74652
Mailing Address - Country:US
Mailing Address - Phone:479-381-0948
Mailing Address - Fax:
Practice Address - Street 1:15370 TULSA DRIVE
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:74652
Practice Address - Country:US
Practice Address - Phone:479-381-0948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0304012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health