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General NPI Number Information
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NPI Number | 1124483367
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Entity Type | Organization
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Legal Business Name | ARKANSAS RELATIONSHIP COUNSELING
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 4 SHACKLEFORD PLZ STE 202
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1826
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Country | US
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Telephone | 501-313-1185
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SHACKLEFORD PLZ STE 202
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1826
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARLIE SIMPSON
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Credential | LPC
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Telephone | 501-313-1185
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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 | P1310099
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License Number State | AR
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