Mosher, Kenyon Mark
Mosher, Kenyon Mark is an sole proprietor health care provider with primary practice located at 2503 Pine St Ste 4 , Arkadelphia AR 71923-4368. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Mosher, Kenyon Mark can be contacted via phone (870) 403-3769.Contact Information
Primary practice address
2503 Pine St Ste 4
Arkadelphia AR 71923-4368
Phone: (870) 403-3769
Fax: (877) 276-1301
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | P110604 | Arkansas |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | P1106034 | Arkansas |
Profile Details
| NPI number | 1184857369 |
|---|---|
| LBN Legal business name | Mosher, Kenyon Mark |
| Credentials | LPC, LADAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 3rd, 2009 |
| Last updated | Aug 12th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184857369 | NPPES |
| Arkansas | MEDICAID | 231767719 | |
| Arkansas | Other | NONE |
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