Basic Information
| Provider Information | |||||||||
| NPI: | 1649726449 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VANTAGE POINT OF NWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4171 N CROSSOVER RD | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727034591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4794436496 | ||||||||
| FaxNumber: | 4794432519 | ||||||||
| Practice Location | |||||||||
| Address1: | 4171 N. CROSSOVER RD | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4794436496 | ||||||||
| FaxNumber: | 4794432519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2016 | ||||||||
| LastUpdateDate: | 08/31/2016 | ||||||||
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| AuthorizedOfficialLastName: | TRAMONTE | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | CATHERINE | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 4794436496 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 1992 C | AR | Y | Agencies | Community/Behavioral Health |
No ID Information.