Healthcare Provider Details

I. General information

NPI: 1215849757
Provider Name (Legal Business Name): EARTHEN VESSEL COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W MOUNTAIN ST STE 306
FAYETTEVILLE AR
72701-6068
US

IV. Provider business mailing address

505 LAKE RD
SPRINGDALE AR
72764-2509
US

V. Phone/Fax

Practice location:
  • Phone: 479-283-7126
  • Fax:
Mailing address:
  • Phone: 479-283-7126
  • Fax:

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: DINA LYNN WELSH
Title or Position: OWNER
Credential: LPC,LMFT
Phone: 479-283-7126