FULFILLED LIFE COUNSELING LLC NPI 1932762754

NPI Information

NPI: 1932762754
Provider Name: FULFILLED LIFE COUNSELING, LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
1218 STONE ST STE 204
JONESBORO, AR
ZIP 72401
Phone: (901) 501-6091
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FULFILLED LIFE COUNSELING, LLC is a professional counselor in Jonesboro, AR. FULFILLED LIFE COUNSELING, LLC NPI is 1932762754. The provider is registered as an organization entity type.

The provider's business location address is:

1218 STONE ST STE 204
JONESBORO, AR
ZIP 72401-568
Phone: (901) 501-6091
Fax: (870) 466-4982

The provider's authorized official is Leonardo Patrick Glover .
The authorized official title is Ceo and has the following contact phone number (870) 718-6199.

The enumeration date for this NPI number is 4/17/2019 and was last updated on 4/17/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
2	101YP2500X	Counselor	Professional			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1093088031	OTHER	ARKANSAS	BCBS
2	1093088031	OTHER	ARKANSAS	QUALCHOICE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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