Healthcare Provider Details

I. General information

NPI: 1851820013
Provider Name (Legal Business Name): MELISSA HUFF LAC, LAMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 CHERRY ST
VAN BUREN AR
72956-4543
US

IV. Provider business mailing address

1304 CHERRY ST
VAN BUREN AR
72956-4543
US

V. Phone/Fax

Practice location:
  • Phone: 479-310-9096
  • Fax:
Mailing address:
  • Phone: 479-310-9096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF2202002
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA2201010
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: