Healthcare Provider Details
I. General information
NPI: 1659287258
Provider Name (Legal Business Name): CULTIVATING SOLACE COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 SMOKEY LN
NORTH LITTLE ROCK AR
72117-2506
US
IV. Provider business mailing address
250 SMOKEY LN
NORTH LITTLE ROCK AR
72117-2506
US
V. Phone/Fax
- Phone: 501-232-3521
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARMAINE
BEASLEY
Title or Position: OWNER/OPERATOR
Credential: LPC-S
Phone: 501-232-3521