Individual
STEPHANIE PAIGE ALSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1425 W MAIN STREET, WALNUT RIDGE, AR 72476-1431
(870) 886-5303
(870) 886-7002
Mailing address
1815 PLEASANT GROVE ROAD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
P1303027
AR
101YP2500X
Professional Counselor
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174003795
—
AR
01
—
5UU03
BCBS
AR
Enumeration date
09/15/2008
Last updated
05/05/2021
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