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General NPI Number Information
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NPI Number | 1982175394
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Entity Type | Organization
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Legal Business Name | TCIY MINISTRIES
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 906 NW 8TH ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-4561
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Country | US
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Telephone | 479-295-3325
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Fax | 888-630-4808
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Provider Business Mailing Address
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Address Line | PO BOX 155
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City | PEA RIDGE
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State | AR
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Zip | 72751-2125
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Country | US
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Telephone | 479-295-3325
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Fax | 888-630-4808
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NIKKI JO SMITH
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Credential |
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Telephone | 479-295-3325
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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 |
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License Number State |
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