Healthcare Provider Details

I. General information

NPI: 1073752275
Provider Name (Legal Business Name): BRIAN KOSTERS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 WHITTINGTON AVE
HOT SPRINGS AR
71901-3406
US

IV. Provider business mailing address

110 PEARSON
BENTON AR
72015-4436
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-3477
  • Fax: 501-624-7498
Mailing address:
  • Phone: 501-315-4224
  • Fax: 501-778-0450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP2305012
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: