Provider Demographics
NPI:1649237785
Name:SYMES, WILLLIAM F JR (MDIV,LPC)
Entity Type:Individual
Prefix:
First Name:WILLLIAM
Middle Name:F
Last Name:SYMES
Suffix:JR
Gender:M
Credentials:MDIV,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-5934
Mailing Address - Country:US
Mailing Address - Phone:479-442-7112
Mailing Address - Fax:479-973-9010
Practice Address - Street 1:230 W CENTER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5934
Practice Address - Country:US
Practice Address - Phone:479-442-7112
Practice Address - Fax:479-973-9010
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8209020101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR50302000-000-7111OtherQUAL CHOICE
AR5S492OtherBLUE CROSS BLUE SHIELD
265502000OtherMAGELLAN
11559660OtherCAQH