Provider Demographics
NPI:1659550762
Name:SOWELL, KIRSTEN LAURA (LCSW)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LAURA
Last Name:SOWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:LAURA
Other - Last Name:SOWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:210 S PULASKI ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201
Mailing Address - Country:US
Mailing Address - Phone:501-833-6988
Mailing Address - Fax:501-200-4888
Practice Address - Street 1:210 S PULASKI ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201
Practice Address - Country:US
Practice Address - Phone:501-833-6988
Practice Address - Fax:501-200-4888
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5737-C101YM0800X, 1041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker