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NPI 1710717343

NPI 1710717343 : ASPIRE FAMILY COUNSELING AND CONSULTING, LLC : FORT SMITH, AR

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General NPI Number Information
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    NPI Number           |    1710717343
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    Entity Type          |    Organization 
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    Legal Business Name  |    ASPIRE FAMILY COUNSELING AND CONSULTING, LLC 
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Dates
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    Enumeration Date     |    08/07/2024
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    Last Update Date     |    08/19/2024
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Provider Practice Location Address
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    Address Line         |    3736 ROGERS AVE 
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    City                 |    FORT SMITH
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    State                |    AR
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    Zip                  |    72903-2984
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    Country              |    US
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    Telephone            |    479-633-7423
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3736 ROGERS AVE 
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    City                 |    FORT SMITH
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    State                |    AR
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    Zip                  |    72903-2984
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    Country              |    US
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    Telephone            |    479-633-7423
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    Fax                  |    833-427-1422
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Authorized Official
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    Title or Position    |    OWNER/THERAPIST
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    Name                 |     KIMBERLY ANN MOORE 
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    Credential           |    LPC, LMFT
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    Telephone            |    479-633-7423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    
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    License Number State |    
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