Healthcare Provider Details

I. General information

NPI: 1689599581
Provider Name (Legal Business Name): WEIRD AND WELL COLLECTIVE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 CALDWELL ST
CONWAY AR
72034-5240
US

IV. Provider business mailing address

1517 CALDWELL ST
CONWAY AR
72034-5240
US

V. Phone/Fax

Practice location:
  • Phone: 501-382-8320
  • Fax: 501-904-8173
Mailing address:
  • Phone: 501-382-8320
  • Fax: 501-904-8173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN JULIANNE SMITH
Title or Position: PRESIDENT
Credential:
Phone: 501-382-8320