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General NPI Number Information
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NPI Number | 1841787090
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Entity Type | Organization
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Legal Business Name | MARTIN COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 1100 N UNIVERSITY AVE STE 210
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City | LITTLE ROCK
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State | AR
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Zip | 72207-6359
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Country | US
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Telephone | 501-246-7121
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Fax | 888-965-4376
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Provider Business Mailing Address
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Address Line | PO BOX 1352
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City | CONWAY
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State | AR
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Zip | 72033-1352
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Country | US
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Telephone | 501-246-7121
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Fax | 888-965-4376
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Authorized Official
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Title or Position | CEO
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Name | ANITA MARTIN
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Credential |
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Telephone | 501-246-7121
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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 | P0307026
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License Number State | AR
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