Healthcare Provider Details

I. General information

NPI: 1881270031
Provider Name (Legal Business Name): THE TALK CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N COLLEGE AVE STE 5
FAYETTEVILLE AR
72701-5343
US

IV. Provider business mailing address

4809 W WALES DR
FAYETTEVILLE AR
72704-5037
US

V. Phone/Fax

Practice location:
  • Phone: 214-793-3655
  • Fax:
Mailing address:
  • Phone: 214-793-3655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE MILLER
Title or Position: CEO
Credential:
Phone: 214-793-3655