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NPI Code Detail

MEDICARE: COUNSELING CLINIC, INC.

MEDICARE: COUNSELING CLINIC, 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
1251S00000XCommunity/Behavioral Health AgencyCERTIFIED (NO NUMBERAR

Other Identifiers

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

General Provider Information

NPI Number : 1578870663
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNSELING CLINIC, INC.
Provider Business Mailing Address
First Line : 110 PEARSON
Second Line :
City : BENTON
State : AR
Zip : 72015-4436
Country : US
Telephone Number : 501-315-4224
Fax Number : 501-778-0450
Provider Business Practice Location Address
First Line : 310 WHITTINGTON AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71901-3406
Country : US
Telephone Number : 501-623-3477
Fax Number : 501-624-7498
Authorized Official
Title or Position : CEO
Name : ROBERT BENNETT
Credential : LCSW
Telephone Number : 501-315-4224
Provider Enumeration Date : 09/10/2010
Last Update Date : 08/24/2023

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Directions to “COUNSELING CLINIC, INC. ” Practice Location

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