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General NPI Number Information
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NPI Number | 1083403430
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Entity Type | Organization
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Legal Business Name | LIVE WELL COUNSELING
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 1845 N GREEN ACRES RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2615
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Country | US
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Telephone | 479-900-2703
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Fax | 855-595-2701
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Provider Business Mailing Address
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Address Line | 1845 N GREEN ACRES RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-2615
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Country | US
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Telephone | 479-713-9879
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | ERICA WALTER
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Credential | LPC
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Telephone | 479-900-2703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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