Provider Demographics
NPI:1679008759
Name:WINGFIELD, ALICIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:WINGFIELD
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 1:41 GREENVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-4648
Mailing Address - Country:US
Mailing Address - Phone:501-837-4487
Mailing Address - Fax:
Practice Address - Street 1:8114 CANTRELL RD STE 250
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-2481
Practice Address - Country:US
Practice Address - Phone:501-771-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7190-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical