Individual
NATHAN GILBERT DERRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
400 W CAPITOL AVE STE 1700, LITTLE ROCK, AR 72201-3438
(646) 941-7645
Mailing address
11 ESTES WAY, SOUTHSIDE, AR 72501-7049
(417) 399-1881
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12124-C
AR
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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