Provider Demographics
NPI:1265149173
Name:TINDALL, JAMILLIA R (PLMSW)
Entity type:Individual
Prefix:
First Name:JAMILLIA
Middle Name:R
Last Name:TINDALL
Suffix:
Gender:F
Credentials:PLMSW
Other - Prefix:
Other - First Name:JAMILLIA
Other - Middle Name:
Other - Last Name:EAKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1707 LINWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5365
Mailing Address - Country:US
Mailing Address - Phone:870-604-4455
Mailing Address - Fax:
Practice Address - Street 1:1707 LINWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5365
Practice Address - Country:US
Practice Address - Phone:870-604-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR171M00000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator