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General NPI Number Information
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NPI Number | 1841639788
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Entity Type | Organization
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Legal Business Name | JOHN SHULER LCSW PLLC
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 221 N EAST AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5226
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Country | US
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Telephone | 479-200-7157
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Fax | 866-751-2593
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Provider Business Mailing Address
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Address Line | 221 N EAST AVE
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5226
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Country | US
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Telephone | 479-200-7157
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Fax | 866-751-2593
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN GARY SHULER
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Credential | LCSW
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Telephone | 479-200-7157
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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 | 1570-C
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License Number State | AR
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