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General NPI Number Information
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NPI Number | 1831650720
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Entity Type | Organization
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Legal Business Name | UNIQUELY INTEGRATED COUNSELING AND CONSULTING LLC
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 3614 EDINBURGH DR
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City | FORT SMITH
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State | AR
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Zip | 72908-8061
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Country | US
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Telephone | 501-651-0349
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Fax | 510-405-0148
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Provider Business Mailing Address
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Address Line | 3614 EDINBURGH DR
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City | FORT SMITH
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State | AR
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Zip | 72908-8061
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Country | US
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Telephone | 501-651-0349
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Fax | 510-405-0148
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. SHAMBRHEE BURTON
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Credential | LCSW
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Telephone | 501-651-0349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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