Healthcare Provider Details

I. General information

NPI: 1184145997
Provider Name (Legal Business Name): COUNSELING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8114 CANTRELL RD STE 240
LITTLE ROCK AR
72227-2495
US

IV. Provider business mailing address

41 GREENVIEW CIR
SHERWOOD AR
72120-4648
US

V. Phone/Fax

Practice location:
  • Phone: 501-219-9245
  • Fax:
Mailing address:
  • Phone: 15018374486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP0108037
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7190-C
License Number StateAR

VIII. Authorized Official

Name: DR. BARRY WINGFIELD
Title or Position: CO OWNER
Credential: PHD, LPC, LMFT
Phone: 501-837-4486