Healthcare Provider Details

I. General information

NPI: 1801456850
Provider Name (Legal Business Name): ALIGN COUNSELING & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 LOCUST AVE
CONWAY AR
72034-5324
US

IV. Provider business mailing address

523 LOCUST AVE
CONWAY AR
72034-5324
US

V. Phone/Fax

Practice location:
  • Phone: 501-208-8062
  • Fax: 501-208-8062
Mailing address:
  • Phone: 501-208-8062
  • 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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KEVIN NATHANIEL PHELPS SPURGERS
Title or Position: OWNER, THERAPIST
Credential: MS, LPC, NCC, TA
Phone: 501-208-8062