Provider Demographics
NPI:1053194787
Name:COUNSELING CENTERS OF ARKANSAS INC
Entity type:Organization
Organization Name:COUNSELING CENTERS OF ARKANSAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-799-8885
Mailing Address - Street 1:429 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72858-8803
Mailing Address - Country:US
Mailing Address - Phone:479-799-8885
Mailing Address - Fax:
Practice Address - Street 1:429 PINE RIDGE RD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72858-8803
Practice Address - Country:US
Practice Address - Phone:479-799-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty