Gentry, James R.

Gentry, James R. is an individual health care provider with primary practice located at 110 Skyline Dr , Russellville AR 72801-3362. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Gentry, James R. can be contacted via phone (479) 968-1298.

Contact Information

Primary practice address
110 Skyline Dr Russellville AR 72801-3362
Phone: (479) 968-1298
Fax: (479) 968-6053
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X P0611062 Arkansas

Profile Details

NPI number 1447376546
LBN Legal business name Gentry, James R.
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Feb 6th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447376546 NPPES
Arkansas MEDICAID 226868719

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