Provider Demographics
NPI:1659722528
Name:SUMMERS, EMILY BRYCE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BRYCE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4701 FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-8066
Mailing Address - Country:US
Mailing Address - Phone:501-771-5335
Mailing Address - Fax:501-771-8263
Practice Address - Street 1:4701 FAIRWAY AVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8066
Practice Address - Country:US
Practice Address - Phone:501-771-5335
Practice Address - Fax:501-771-8263
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7918-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical