Healthcare Provider Details

I. General information

NPI: 1992279731
Provider Name (Legal Business Name): RESOLUTIONS BEHAVIORAL HEALTH SERVICE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 MAIN ST
CROSSETT AR
71635-2928
US

IV. Provider business mailing address

PO BOX 562
CROSSETT AR
71635-0562
US

V. Phone/Fax

Practice location:
  • Phone: 870-305-1221
  • Fax: 870-364-9774
Mailing address:
  • Phone: 870-500-2324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA C JOHNSON-MARTIN
Title or Position: OWNER
Credential: LCSSW
Phone: 870-500-2324