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General NPI Number Information
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NPI Number | 1740089929
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Entity Type | Organization
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Legal Business Name | MENTAL WELLNESS CONNECTION
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 513 MAIN ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-5329
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Country | US
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Telephone | 501-777-5969
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Fax |
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Provider Business Mailing Address
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Address Line | 513 MAIN ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-5329
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Country | US
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Telephone | 501-777-5969
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KELLEE MCCOY
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Credential | LPC, LMFT
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Telephone | 501-722-3264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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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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