# PSYCHE NWA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598644700
- **Authorized official:** MATTHEW CASEY JONES CRNA (OWNER)
- **Authorized official phone:** (870) 378-1876

## Contact information

- **Practice address:** 5212 W VILLAGE PKWY STE 8, ROGERS, AR 72758-8190
- **Practice address phone:** (904) 894-9260
- **Mailing address:** 5212 W VILLAGE PKWY STE 8, ROGERS, AR 72758-8190
- **Mailing address phone:** (479) 324-2671
- **Mailing address fax:** (479) 398-8346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 09/01/2025
- **Last updated:** 09/22/2025