Healthcare Provider Details

I. General information

NPI: 1114405347
Provider Name (Legal Business Name): LIFE STRATEGIES COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 POPLAR PL
ROGERS AR
72756-4249
US

IV. Provider business mailing address

2200 E MATTHEWS AVE
JONESBORO AR
72401-4347
US

V. Phone/Fax

Practice location:
  • Phone: 479-372-6464
  • Fax: 479-372-6460
Mailing address:
  • Phone: 866-972-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAVIER MALAVE
Title or Position: CEO
Credential:
Phone: 904-605-4986