Healthcare Provider Details

I. General information

NPI: 1558082362
Provider Name (Legal Business Name): EMERGING HOPE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W MAIN PL
RUSSELLVILLE AR
72801-3510
US

IV. Provider business mailing address

910 W MAIN PL
RUSSELLVILLE AR
72801-3510
US

V. Phone/Fax

Practice location:
  • Phone: 479-518-3135
  • Fax: 479-500-1353
Mailing address:
  • Phone: 479-518-3135
  • Fax: 479-500-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MEAGAN BEERMAN
Title or Position: OWNER/THERAPIST
Credential: MS, LPC
Phone: 479-500-1353