Provider Demographics
NPI:1639407554
Name:CARA HARTFIELD PHD LICENSED PSYCHOLOGIST PLC
Entity Type:Organization
Organization Name:CARA HARTFIELD PHD LICENSED PSYCHOLOGIST PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:HARTFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:479-409-2212
Mailing Address - Street 1:112 W CENTER ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-6073
Mailing Address - Country:US
Mailing Address - Phone:479-409-2212
Mailing Address - Fax:479-439-8550
Practice Address - Street 1:112 W CENTER ST
Practice Address - Street 2:SUITE 215
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-6073
Practice Address - Country:US
Practice Address - Phone:479-409-2212
Practice Address - Fax:479-439-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR06-15P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty