Provider Demographics
NPI:1730269010
Name:POOLE, SUE W (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUE
Middle Name:W
Last Name:POOLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:125 DONS WAY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913
Mailing Address - Country:US
Mailing Address - Phone:501-620-5130
Mailing Address - Fax:501-620-5109
Practice Address - Street 1:201 N 26TH ST
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4336
Practice Address - Country:US
Practice Address - Phone:870-246-4123
Practice Address - Fax:501-620-5109
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1771-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116399726Medicaid
AR1070032OtherUSA MANAGED CARE
AR2325123OtherCIGNA BEHAVIORAL HEALTH
AR710401764POOOtherUNITY MANAGED HEALTH CARE
AR06110016300OtherQUAL CHOICE
AR1730269010OtherVALUE OPTIONS
AR389961OtherMHN NETWORK
AR71-0401764OtherCORPHEALTH
710401764OtherARK COMMUNITY CARE
AR710401764OtherCORP HEALTH
AR710401764OtherNOVASYS
AR5A054OtherBLUE CROSS & BLUE SHIELD
710401764OtherARK COMMUNITY CARE
AR71-0401764OtherCORPHEALTH