MEDICARE: HEBER SPRINGS COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	P1412107	AR

General Provider Information

NPI Number	:	1255834081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEBER SPRINGS COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	104 N 3RD ST
Second Line	:
City	:	HEBER SPRINGS
State	:	AR
Zip	:	72543-3035
Country	:	US
Telephone Number	:	501-270-9503
Fax Number	:	501-764-4231

Provider Business Practice Location Address
First Line	:	301 W SEARCY ST
Second Line	:
City	:	HEBER SPRINGS
State	:	AR
Zip	:	72543-3840
Country	:	US
Telephone Number	:	501-270-9503
Fax Number	:	501-235-3866

Authorized Official
Title or Position	:	OWNER
Name	:	MS. BERNADETTE STANFORD
Credential	:	LPC
Telephone Number	:	501-270-9503

Provider Enumeration Date	:	03/18/2018
Last Update Date	:	09/27/2023

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