NPI Code Details Logo

NPI 1851055172

NPI 1851055172 : W. GRACE COUNSELING PLLC : BENTON, AR

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1851055172
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    W. GRACE COUNSELING PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/22/2021
-----------------------------------------------------
    Last Update Date     |    09/15/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2806 W GREENBRIER 
-----------------------------------------------------
    City                 |    BENTON
-----------------------------------------------------
    State                |    AR
-----------------------------------------------------
    Zip                  |    72015-2678
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    501-920-5945
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2806 W GREENBRIER 
-----------------------------------------------------
    City                 |    BENTON
-----------------------------------------------------
    State                |    AR
-----------------------------------------------------
    Zip                  |    72015-2678
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    501-920-5945
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     WENDY  LOGSDON 
-----------------------------------------------------
    Credential           |    LCSW
-----------------------------------------------------
    Telephone            |    501-920-5945
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.