SYSTEMIC FAMILY THERAPY LLC NPI 1871039883

NPI Information

  • NPI: 1871039883
  • Provider Name: SYSTEMIC FAMILY THERAPY LLC
  • Classification: Preferred Provider Organization - 305R00000X
  • Entity Type: Organization
  • Address: 17724 I 30 STE 2 OFC 5
    BENTON, AR
    ZIP 72019
  • Phone: (501) 400-6570

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NPI Details

SYSTEMIC FAMILY THERAPY LLC is a preferred provider organization in Benton, AR. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. SYSTEMIC FAMILY THERAPY LLC NPI is 1871039883. The provider is registered as an organization entity type.

The provider's business location address is:

17724 I 30 STE 2 OFC 5
BENTON, AR
ZIP 72019-907
Phone: (501) 400-6570

The provider's authorized official is Elizabeth Ruggiero Wallis .
The authorized official title is Therapist and has the following contact phone number (501) 400-6570.

The enumeration date for this NPI number is 1/13/2017 and was last updated on 6/24/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305R00000XPreferred Provider OrganizationMO704002ARKANSASNo
2305R00000XPreferred Provider OrganizationPO807061ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11699966697OTHERARKANSASNPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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