Healthcare Provider Details
I. General information
NPI: 1497506687
Provider Name (Legal Business Name): PAT J BRUNO DBA THREE STRANDS MENTAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2024
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
105 RHONDA LN
ROSE BUD AR
72137-8003
US
IV. Provider business mailing address
105 RHONDA LN
ROSE BUD AR
72137-8003
US
V. Phone/Fax
- Phone: 501-827-8134
- Fax: 479-763-0105
- Phone: 501-827-8134
- Fax: 479-763-0105
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP1600X |
| Taxonomy | Pastoral Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAT
J.
BRUNO
Title or Position: OWNER
Credential: LCSW
Phone: 501-827-8136