Healthcare Provider Details

I. General information

NPI: 1699688622
Provider Name (Legal Business Name): FINISH LINE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101A W CENTRAL ST
WARREN AR
71671-2823
US

IV. Provider business mailing address

101A W CENTRAL ST
WARREN AR
71671-2823
US

V. Phone/Fax

Practice location:
  • Phone: 870-820-9060
  • Fax:
Mailing address:
  • Phone:
  • 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: SCOTT ALLISON RICHARDSON JOHNSON
Title or Position: CEO
Credential: LCSW
Phone: 870-820-9060