Provider Demographics
NPI:1770580284
Name:HEMINGWAY, JOAN (MSW,LCSW)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:HEMINGWAY
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6659
Mailing Address - Country:US
Mailing Address - Phone:501-225-0576
Mailing Address - Fax:501-225-6789
Practice Address - Street 1:11500 W 36TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4612
Practice Address - Country:US
Practice Address - Phone:501-224-4900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR718-C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5S115OtherLOCAL BCBS
AR5S115Medicare ID - Type UnspecifiedMEDICARE