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General NPI Number Information
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NPI Number | 1649381120
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Entity Type | Organization
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Legal Business Name | COUNSELING ASSOCIATES INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 110 SKYLINE DRIVE
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City | RUSSELLVILLE
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State | AR
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Zip | 72801
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Country | US
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Telephone | 479-968-1298
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Fax | 479-968-6053
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Provider Business Mailing Address
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Address Line | 2400 S 48TH ST
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City | SPRINGDALE
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State | AR
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Zip | 72762-6683
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Country | US
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Telephone | 479-967-5570
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Fax | 479-890-5364
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | LAURA TYLER
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Credential | PHD
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Telephone | 479-750-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | AR
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