Healthcare Provider Details
I. General information
NPI: 1063843316
Provider Name (Legal Business Name): HOT SPRINGS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
146 FILES RD
HOT SPRINGS AR
71913-6914
US
IV. Provider business mailing address
146 FILES RD
HOT SPRINGS AR
71913-6914
US
V. Phone/Fax
- Phone: 501-545-8461
- Fax:
- Phone: 501-545-8461
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | PO808067 |
| License Number State | AR |
VIII. Authorized Official
Name: MS.
NANCY
D.
GRANT-HORN
Title or Position: OWNER
Credential: LPC
Phone: 501-545-8461