Healthcare Provider Details

I. General information

NPI: 1366255358
Provider Name (Legal Business Name): 206 COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 LEVESQUE AVE E
WYNNE AR
72396-2938
US

IV. Provider business mailing address

206 LEVESQUE AVE E
WYNNE AR
72396-2938
US

V. Phone/Fax

Practice location:
  • Phone: 870-587-3102
  • Fax:
Mailing address:
  • Phone: 870-587-3102
  • 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: CALLIE SWAITE
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LPC
Phone: 870-318-5623