Healthcare Provider Details

I. General information

NPI: 1184272072
Provider Name (Legal Business Name): ARKILA 360 DEGREES COUNSELING AND CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S 4TH ST STE 550
SAINT LOUIS MO
63102-1897
US

IV. Provider business mailing address

PO BOX 771582
SAINT LOUIS MO
63177-1582
US

V. Phone/Fax

Practice location:
  • Phone: 314-578-7394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. ARKILA COVINGTON
Title or Position: EXECUTIVE DIRECTOR
Credential: LMFT
Phone: 314-578-7394