MEDICARE: S&E COUNSELING SERVICES 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1356093173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S&E COUNSELING SERVICES PLLC

Provider Business Mailing Address
First Line	:	7613 VESTAL BLVD APT 10
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72113-7272
Country	:	US
Telephone Number	:	501-508-1481
Fax Number	:

Provider Business Practice Location Address
First Line	:	7613 VESTAL BLVD APT 10
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72113-7272
Country	:	US
Telephone Number	:	501-508-1481
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	RHONDA LASHELLE JOHNSON
Credential	:	LPC
Telephone Number	:	501-508-1481

Provider Enumeration Date	:	01/23/2022
Last Update Date	:	09/03/2022

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