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General NPI Number Information
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NPI Number | 1629868989
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Entity Type | Organization
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Legal Business Name | CET OF ARKANSAS LLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1201 N. MISSOURI ST. SUITE A1
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-2621
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Country | US
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Telephone | 870-735-2588
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Fax | 870-629-5179
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Provider Business Mailing Address
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Address Line | 2470 CAPEWOOD DR.
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City | MEMPHIS
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State | TN
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Zip | 38127-8332
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Country | US
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Telephone | 901-482-7633
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Fax | 870-629-5179
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Authorized Official
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Title or Position | CEO
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Name | MR. CHARLES E THIGPEN
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Credential | LCSW
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Telephone | 901-482-7633
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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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