Provider Demographics
NPI:1366560369
Name:PREWETT, PHILIP A (LPC, LADAC, ACADC)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:A
Last Name:PREWETT
Suffix:
Gender:M
Credentials:LPC, LADAC, ACADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MERGANSER TRL
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8896
Mailing Address - Country:US
Mailing Address - Phone:501-538-9142
Mailing Address - Fax:
Practice Address - Street 1:106 RIDGEWAY ST
Practice Address - Street 2:SUITE G & H
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7100
Practice Address - Country:US
Practice Address - Phone:501-609-0400
Practice Address - Fax:501-609-0166
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9908021101Y00000X
AR0056L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)