Healthcare Provider Details

I. General information

NPI: 1619881950
Provider Name (Legal Business Name): INDIGO COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3729 N CROSSOVER RD STE 103
FAYETTEVILLE AR
72703-5538
US

IV. Provider business mailing address

23450 COUNTY ROAD 554
COLCORD OK
74338-4631
US

V. Phone/Fax

Practice location:
  • Phone: 479-220-2383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMANDA AMANDA DUNN
Title or Position: OWNER
Credential: LCSW
Phone: 479-220-2383