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General NPI Number Information
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NPI Number | 1366685315
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Entity Type | Individual
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Provider Name | THADDEUS ELDER LPC
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Gender | Male
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 100 RIDGEWAY ST STE 1
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City | HOT SPRINGS
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State | AR
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Zip | 71901-7155
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Country | US
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Telephone | 501-545-6420
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Fax | 501-623-2266
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Provider Business Mailing Address
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Address Line | 100 RIDGEWAY ST STE 1
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City | HOT SPRINGS
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State | AR
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Zip | 71901-7155
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Country | US
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Telephone | 501-545-6420
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Fax | 501-623-2266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | P1312117
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License Number State | AR
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