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General NPI Number Information
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NPI Number | 1508587023
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Entity Type | Organization
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Legal Business Name | INVICTA COUNSELING
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 711 S MOUNT OLIVE ST
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City | SILOAM SPRINGS
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State | AR
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Zip | 72761-3645
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Country | US
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Telephone | 479-220-2337
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Fax | 501-222-8784
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Provider Business Mailing Address
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Address Line | 994 N MOSELEY RD
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City | COLCORD
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State | OK
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Zip | 74338-3383
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Country | US
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Telephone | 479-228-1120
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Fax | 501-222-8784
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Authorized Official
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Title or Position | OWNER
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Name | AMY RUSK
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Credential |
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Telephone | 479-220-2337
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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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