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General NPI Number Information
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NPI Number | 1932071982
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Entity Type | Individual
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Provider Name | ASHTYN BROOKE BECK LAC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1718 S GRANDVIEW DR
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City | DE WITT
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State | AR
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Zip | 72042-3449
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Country | US
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Telephone | 870-946-4651
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Fax |
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Provider Business Mailing Address
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Address Line | 821 W 5TH ST
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City | DE WITT
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State | AR
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Zip | 72042-2303
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Country | US
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Telephone | 870-509-1150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | A2507025
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License Number State | AR
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