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General NPI Number Information
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NPI Number | 1477141489
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Entity Type | Individual
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Provider Name | PETER MCCOLLOUGH QBHP
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Gender | Male
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 5111 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72903-2047
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Country | US
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Telephone | 479-222-0268
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Fax |
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Provider Business Mailing Address
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Address Line | 5111 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72903-2047
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Country | US
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Telephone |
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Fax | 479-927-1373
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | AR
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