Healthcare Provider Details

I. General information

NPI: 1346711181
Provider Name (Legal Business Name): COLLINS FAMILY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W SEARCY ST
HEBER SPRINGS AR
72543-3840
US

IV. Provider business mailing address

301 W SEARCY ST
HEBER SPRINGS AR
72543-3840
US

V. Phone/Fax

Practice location:
  • Phone: 501-270-4011
  • Fax: 501-207-0436
Mailing address:
  • Phone: 501-270-4011
  • Fax: 501-207-0436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. SKY MARIE COLLINS
Title or Position: MANAGER
Credential: LMSW
Phone: 501-270-4011