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General NPI Number Information
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NPI Number | 1043951213
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL PATH COUNSELING LLC
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Dates
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Enumeration Date | 04/04/2022
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1305 E MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-5322
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Country | US
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Telephone | 501-500-1545
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Fax | 479-777-9928
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Provider Business Mailing Address
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Address Line | 37 WILLIAMSBURG LN
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City | PERRYVILLE
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State | AR
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Zip | 72126-8686
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Country | US
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Telephone | 501-889-4880
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Fax | 479-777-9928
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Authorized Official
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Title or Position | OWNER
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Name | MR. GERALD DWAYNE WEBB
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Credential | LPC
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Telephone | 501-889-4880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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