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General NPI Number Information
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NPI Number | 1851230486
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Entity Type | Organization
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Legal Business Name | PURPLE W.I.N.G.S COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 2090 TALLGRASS TER
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City | CENTERTON
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State | AR
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Zip | 72719-4039
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Country | US
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Telephone | 479-236-3585
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 TALLGRASS TER
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City | CENTERTON
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State | AR
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Zip | 72719-4039
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Country | US
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Telephone | 479-236-3585
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHULYNDRIA LAYE
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Credential |
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Telephone | 479-236-3585
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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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