Individual
TYNESHA IVORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1500 N MISSISSIPPI ST, LITTLE ROCK, AR 72207-5851
(501) 217-8600
Mailing address
10618 BRECKENRIDGE DR, LITTLE ROCK, AR 72211-1802
(501) 217-8600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A2111000
AR
101YP2500X
Professional Counselor
Primary
P2407019
AR
171M00000X
Case Manager/Care Coordinator
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278537795
—
AR
Enumeration date
07/18/2013
Last updated
11/08/2024
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