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General NPI Number Information
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NPI Number | 1104692193
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Entity Type | Organization
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Legal Business Name | CARE COUNSELING SERVICES
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 217 W 2ND ST STE 306
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City | LITTLE ROCK
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State | AR
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Zip | 72201-2522
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Country | US
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Telephone | 501-412-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 9214 TALL TIMBER BLVD
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City | LITTLE ROCK
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State | AR
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Zip | 72204-8523
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Country | US
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Telephone | 501-247-0252
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Fax | 501-712-4534
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Authorized Official
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Title or Position | OWNER/LICENSED THERAPIST
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Name | CRYSTAL STIDUM
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Credential | LPC
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Telephone | 501-412-0069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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