Provider Demographics
NPI:1356742464
Name:HEDGES, ZACHARY S (LPC)
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:S
Last Name:HEDGES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 SW HAZELNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72713-3195
Mailing Address - Country:US
Mailing Address - Phone:479-636-0083
Mailing Address - Fax:479-636-0144
Practice Address - Street 1:3700 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3222
Practice Address - Country:US
Practice Address - Phone:479-721-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1907089101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR235478719Medicaid