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General NPI Number Information
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NPI Number | 1467160010
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Entity Type | Organization
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Legal Business Name | VITALITY COUNSELING, PLLC
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 6901 DALLAS ST STE A
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City | FORT SMITH
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State | AR
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Zip | 72903-5037
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Country | US
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Telephone | 479-650-9970
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Fax |
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Provider Business Mailing Address
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Address Line | 1906 N 29TH ST
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City | VAN BUREN
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State | AR
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Zip | 72956-2418
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Country | US
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Telephone | 479-650-9970
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | KATELYN NABORS
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Credential | LPC
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Telephone | 479-650-9970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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