Provider Demographics
NPI:1730629197
Name:STOW, EMILY SUZANNE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUZANNE
Last Name:STOW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:SUZANNE
Other - Last Name:GATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10800 FINANCIAL PKWY.
Mailing Address - Street 2:STE. 290
Mailing Address - City:WEST LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211
Mailing Address - Country:US
Mailing Address - Phone:501-781-2230
Mailing Address - Fax:870-933-9395
Practice Address - Street 1:800 EXCHANGE AVE.
Practice Address - Street 2:STE. 103
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032
Practice Address - Country:US
Practice Address - Phone:501-781-2230
Practice Address - Fax:501-982-5007
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 171M00000X
AR10229-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR224580795Medicaid