Healthcare Provider Details

I. General information

NPI: 1235119082
Provider Name (Legal Business Name): BILLY ENGLES LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 GAP RD
BATESVILLE AR
72501-8679
US

IV. Provider business mailing address

35 CHALET ST
CABOT AR
72023-2801
US

V. Phone/Fax

Practice location:
  • Phone: 870-793-8900
  • Fax:
Mailing address:
  • Phone: 501-843-9633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberM9808034
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: