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General NPI Number Information
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NPI Number | 1073722344
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Entity Type | Organization
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Legal Business Name | NORTHWEST ARKANSAS COUNSELING INC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 130 N SPRING ST
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City | SPRINGDALE
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State | AR
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Zip | 72764
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Country | US
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Telephone | 479-751-5704
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Fax |
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Provider Business Mailing Address
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Address Line | 130 N SPRING ST
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City | SPRINGDALE
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State | AR
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Zip | 72764
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Country | US
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Telephone | 479-751-5704
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM DUANE OLDHAM
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Credential | LPC
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Telephone | 479-751-5704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | P0407033
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License Number State | AR
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