Provider Demographics
NPI:1699811042
Name:SMALLMAN, LINDA R (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:SMALLMAN
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 1:2010 CHESTNUT ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-5321
Mailing Address - Country:US
Mailing Address - Phone:479-474-9555
Mailing Address - Fax:479-474-9574
Practice Address - Street 1:2010 CHESTNUT ST
Practice Address - Street 2:SUITE D
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-5321
Practice Address - Country:US
Practice Address - Phone:479-474-9555
Practice Address - Fax:479-474-9574
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2365-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical