Healthcare Provider Details

I. General information

NPI: 1982904389
Provider Name (Legal Business Name): LINDA K INGLE, LPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 MISSISSIPPI ST S STE A
WYNNE AR
72396-3000
US

IV. Provider business mailing address

222 MISSISSIPPI ST S STE A
WYNNE AR
72396-3000
US

V. Phone/Fax

Practice location:
  • Phone: 870-208-3311
  • Fax: 870-238-5483
Mailing address:
  • Phone: 870-208-3311
  • Fax: 870-238-5483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP0612069
License Number StateAR

VIII. Authorized Official

Name: LINDA K. INGLE
Title or Position: OWNER
Credential: LPC
Phone: 870-208-3311