Provider Demographics
NPI:1881878478
Name:ATCHLEY, MONTY LEE (EDD/LPC/LMFT)
Entity type:Individual
Prefix:DR
First Name:MONTY
Middle Name:LEE
Last Name:ATCHLEY
Suffix:
Gender:M
Credentials:EDD/LPC/LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-0057
Mailing Address - Country:US
Mailing Address - Phone:479-206-1650
Mailing Address - Fax:
Practice Address - Street 1:16135 HIGHWAY 71 S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936-7218
Practice Address - Country:US
Practice Address - Phone:479-206-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0503017101YP2500X
ARM0507007106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR174678719Medicaid