Basic Information
| Provider Information | |||||||||
| NPI: | 1295860351 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EIFLING | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 251970 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722251970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5046668686 | ||||||||
| FaxNumber: | 5016606830 | ||||||||
| Practice Location | |||||||||
| Address1: | 5905 FOREST PL | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722075244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016664949 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1140-C | AR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.