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General NPI Number Information
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NPI Number | 1427419266
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Entity Type | Organization
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Legal Business Name | PLAYFUL PATH COUNSELING, LLC
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 4943 OLD GREENWOOD RD STE 8
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City | FORT SMITH
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State | AR
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Zip | 72903-6923
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Country | US
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Telephone | 479-274-8132
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Fax | 479-431-4430
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Provider Business Mailing Address
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Address Line | 4943 OLD GREENWOOD RD STE 8
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City | FORT SMITH
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State | AR
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Zip | 72903-6923
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Country | US
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Telephone | 479-274-8132
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Fax | 479-431-4430
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Authorized Official
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Title or Position | OWNER
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Name | ERICA HUTCHISON
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Credential | LPC-S
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Telephone | 479-274-8132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 869-C
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P0906036
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License Number State | AR
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