Individual
MRS. JESSICA CARRIE KITCHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LADAC, RPT, MAC
Contact information
Practice address
4210 FRONTAGE RD., FAYETTEVILLE, AR 72703-5001
(479) 200-0965
(479) 935-9187
Mailing address
1189 LEELYNJEAN LN, SPRINGDALE, AR 72762-0801
(479) 200-0965
(479) 935-9187
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
347L
AR
101YA0400X
Addiction (Substance Use Disorder) Counselor
508408
VA
101YP2500X
Professional Counselor
Primary
P1206062
AR
Other
Enumeration date
08/18/2011
Last updated
03/24/2017
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