Provider Demographics
NPI:1437339157
Name:GRAUPNER, REBA MAE (LCSW)
Entity Type:Individual
Prefix:
First Name:REBA
Middle Name:MAE
Last Name:GRAUPNER
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 1:1600 ALDERSGATE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6676
Mailing Address - Country:US
Mailing Address - Phone:501-661-0720
Mailing Address - Fax:501-325-7938
Practice Address - Street 1:201 E SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AR
Practice Address - Zip Code:72744
Practice Address - Country:US
Practice Address - Phone:479-466-7858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2332-C104100000X, 1041C0700X
AR1989-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker