Provider Demographics
NPI:1760742373
Name:JAMES R MONEYPENNY PHD PA
Entity Type:Organization
Organization Name:JAMES R MONEYPENNY PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:MONEYPENNY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:501-227-7044
Mailing Address - Street 1:8500 W MARKHAM ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2453
Mailing Address - Country:US
Mailing Address - Phone:501-227-7044
Mailing Address - Fax:
Practice Address - Street 1:8500 W MARKHAM ST
Practice Address - Street 2:SUITE 305
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2453
Practice Address - Country:US
Practice Address - Phone:501-227-7044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR 82-15P103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105182719Medicaid