Healthcare Provider Details

I. General information

NPI: 1548012891
Provider Name (Legal Business Name): PEELER COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 04/02/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7514 HWY 107
SHERWOOD AR
72120
US

IV. Provider business mailing address

7514 HWY 107
SHERWOOD AR
72120
US

V. Phone/Fax

Practice location:
  • Phone: 501-912-3979
  • Fax:
Mailing address:
  • Phone: 501-864-6909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: CALVIN LIN PEELER
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LPC
Phone: 501-864-6909