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General NPI Number Information
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NPI Number | 1922499557
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Entity Type | Organization
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Legal Business Name | GROWING HOPE COUNSELING PLLC
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 217 W MAIN ST
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City | CABOT
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State | AR
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Zip | 72023-2944
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Country | US
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Telephone | 501-743-9470
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Fax | 501-843-1217
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Provider Business Mailing Address
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Address Line | 41 GLENDALE DR
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City | CABOT
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State | AR
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Zip | 72023-2467
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Country | US
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Telephone | 501-743-9470
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Fax | 501-843-1217
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MS. GLENDA SUE EVERSOLE
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Credential | LCSW
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Telephone | 501-743-9470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3887-C
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License Number State | AR
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