Organization
THE GREEN FERN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE FUGERE LCSW 7926-C (ORGANIZER/MANAGER/OFFICER)
(501) 794-9496
Entity
Organization
Contact information
Practice address
900 S SHACKLEFORD RD, LITTLE ROCK, AR 72211-3817
(501) 794-9496
Mailing address
PO BOX 1853, BENTON, AR 72018-1853
(501) 794-9496
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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