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NPI Code Detail

MEDICARE: WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC

MEDICARE: WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)AR
2251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326040692
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC
Provider Business Mailing Address
First Line : PO BOX 11818
Second Line :
City : FORT SMITH
State : AR
Zip : 72917-1818
Country : US
Telephone Number : 479-452-6650
Fax Number : 479-452-5847
Provider Business Practice Location Address
First Line : 3111 S 70TH ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5017
Country : US
Telephone Number : 479-452-6650
Fax Number : 479-452-5847
Authorized Official
Title or Position : CEO
Name : MRS. AARON R HOLWICK
Credential : LPE-I
Telephone Number : 479-452-6650
Provider Enumeration Date : 06/01/2005
Last Update Date : 06/13/2024

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Directions to “WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC ” Practice Location

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