Healthcare Provider Details

I. General information

NPI: 1700750452
Provider Name (Legal Business Name): OAK STREET COUNSELING AND ASSESSMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 OAK ST STE 303
CONWAY AR
72032-4359
US

IV. Provider business mailing address

1125 OAK ST STE 303
CONWAY AR
72032-4359
US

V. Phone/Fax

Practice location:
  • Phone: 479-858-1693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW JORDAN STRICKLAND
Title or Position: OWNER
Credential: LPE, LPC
Phone: 479-858-1693