=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508024613
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OUACHITA COUNSELING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2008
-----------------------------------------------------
Last Update Date | 05/05/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1142 HIGHWAY 71 S STE C
-----------------------------------------------------
City | MENA
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71953-8078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-437-7967
-----------------------------------------------------
Fax | 479-385-0260
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1142 HIGHWAY 71 S STE C
-----------------------------------------------------
City | MENA
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71953-8078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-437-7967
-----------------------------------------------------
Fax | 479-385-0260
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OPERATING OFFICER
-----------------------------------------------------
Name | MRS. RHONDA COWART PEPPERS
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 479-437-7967
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------