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Individual

EDWARD J PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CYC, CIT-HS-00158

Contact information

Practice address
1521 MERRILL DRIVE, STE D220, LITTLE ROCK, AR 72211
(501) 666-8686
(501) 660-6830
Mailing address
PO BOX 251970, LITTLE ROCK, AR 72225
(501) 666-8686
(501) 660-6830

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CIT-HS-00158
AR
171M00000X
Case Manager/Care Coordinator
Primary
AR

Other

Enumeration date
11/09/2021
Last updated
07/20/2022
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