Healthcare Provider Details

I. General information

NPI: 1962636563
Provider Name (Legal Business Name): GLOBAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SILEBY LN
BELLA VISTA AR
72714-4324
US

IV. Provider business mailing address

1 SILEBY LN
BELLA VISTA AR
72714-4324
US

V. Phone/Fax

Practice location:
  • Phone: 479-206-3627
  • Fax: 866-584-0449
Mailing address:
  • Phone: 479-206-3627
  • Fax: 866-584-0449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW3309
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2505-C
License Number StateAR

VIII. Authorized Official

Name: DONNA M HUNTER
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 479-206-3627