Healthcare Provider Details

I. General information

NPI: 1851230486
Provider Name (Legal Business Name): PURPLE W.I.N.G.S COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 TALLGRASS TER
CENTERTON AR
72719-4039
US

IV. Provider business mailing address

2090 TALLGRASS TER
CENTERTON AR
72719-4039
US

V. Phone/Fax

Practice location:
  • Phone: 479-236-3585
  • Fax:
Mailing address:
  • Phone: 479-236-3585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHULYNDRIA LAYE
Title or Position: MANAGER
Credential:
Phone: 479-236-3585