Healthcare Provider Details

I. General information

NPI: 1487576948
Provider Name (Legal Business Name): KELLY STEPHENS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 FOUR MILE HILL RD
VILONIA AR
72173-5001
US

IV. Provider business mailing address

23 FOUR MILE HILL RD
VILONIA AR
72173-5001
US

V. Phone/Fax

Practice location:
  • Phone: 501-908-2897
  • Fax:
Mailing address:
  • Phone: 501-908-2897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KELLY POGUE STEPHENS
Title or Position: MEMBER/ORGANIZER
Credential: LPC/LAMFT
Phone: 501-908-2897