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General NPI Number Information
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NPI Number | 1164931291
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Entity Type | Organization
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Legal Business Name | PT CONCEPTS, PLLC
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 204 S 24TH ST
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City | ROGERS
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State | AR
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Zip | 72758-1129
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Country | US
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Telephone | 479-621-0301
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Fax | 479-866-6300
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Provider Business Mailing Address
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Address Line | PO BOX 1509
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City | ROGERS
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State | AR
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Zip | 72757-1509
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Country | US
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Telephone | 479-621-0301
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Fax | 479-866-6300
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Authorized Official
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Title or Position | DOO
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Name | GABRIELA VIVEROS
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Credential |
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Telephone | 479-925-8543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | P1103020
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License Number State | AR
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