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General NPI Number Information
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NPI Number | 1497210199
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE COUNSELING CENTER LLC
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Dates
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Enumeration Date | 02/06/2019
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 204 EXECUTIVE CT STE 110
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City | LITTLE ROCK
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State | AR
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Zip | 72205-4531
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Country | US
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Telephone | 501-416-4356
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Fax | 501-725-8952
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Provider Business Mailing Address
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Address Line | 204 EXECUTIVE CT STE 110
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City | LITTLE ROCK
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State | AR
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Zip | 72205-4531
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Country | US
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Telephone | 501-416-4356
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Fax | 501-725-8952
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Authorized Official
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Title or Position | THERAPIST/CO-OWNER
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Name | CANDACE CARTER
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Credential |
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Telephone | 501-416-4356
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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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