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General NPI Number Information
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NPI Number | 1578359568
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Entity Type | Organization
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Legal Business Name | BOCKELMAN COUNSELING LLC
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 808 S WALTON BLVD
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City | BENTONVILLE
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State | AR
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Zip | 72712-6235
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Country | US
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Telephone | 479-200-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 6405 S 37TH ST
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City | ROGERS
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State | AR
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Zip | 72758-1619
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Country | US
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Telephone | 479-200-4248
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MALLORY BOCKELMAN
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Credential | LPC
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Telephone | 479-200-4248
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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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