Provider Demographics
NPI:1841426103
Name:DOBBINS, AUDREY KATHRYN (LPC)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:KATHRYN
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 SOUTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5829
Mailing Address - Country:US
Mailing Address - Phone:870-203-6100
Mailing Address - Fax:800-421-5290
Practice Address - Street 1:262 SOUTHWEST DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5829
Practice Address - Country:US
Practice Address - Phone:870-203-6100
Practice Address - Fax:800-421-5290
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1304042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR177060795Medicaid
AR5TT93OtherBCBS