Healthcare Provider Details

I. General information

NPI: 1952231128
Provider Name (Legal Business Name): REFRAME FAMILY THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 3RD ST
MALVERN AR
72104-3717
US

IV. Provider business mailing address

315 W 3RD ST
MALVERN AR
72104-3717
US

V. Phone/Fax

Practice location:
  • Phone: 501-802-0107
  • Fax: 888-892-4015
Mailing address:
  • Phone: 501-802-0107
  • Fax: 888-892-4015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY ELIZABETH BACON-LATINA
Title or Position: OWNER/COUNSELOR
Credential: LPC/LMFT
Phone: 918-430-5284