Provider Demographics
NPI:1538589205
Name:TRAN, KAMIRON (LPC)
Entity type:Individual
Prefix:
First Name:KAMIRON
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 EXCHANGE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-7836
Mailing Address - Country:US
Mailing Address - Phone:501-328-3274
Mailing Address - Fax:501-358-6264
Practice Address - Street 1:12921 CANTRELL RD STE 105
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1798
Practice Address - Country:US
Practice Address - Phone:501-891-5492
Practice Address - Fax:501-747-2149
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARP1611179101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional